Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $77.62 / $100.00	Facility	26	$53.70	$77.62	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $575.44	Professional		$131.83	$218.78	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $74.13 / $169.82	Professional	26	$53.70	$74.13	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $120.23 / $281.84	Professional	TC	$79.43	$120.23	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $128.82	Professional		$91.20	$107.15	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $69.18 / $107.15	Professional	26	$41.69	$69.18	$107.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $102.33 / $151.36	Professional	TC	$102.33	$102.33	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $446.68	Professional		$154.88	$186.21	$446.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $66.07 / $109.65	Professional	26	$63.10	$66.07	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $100.00 / $331.13	Professional	TC	$91.20	$100.00	$331.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $162.18	Professional		$57.54	$85.11	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	26	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $338.84 / $1,202.26	Professional		$162.18	$338.84	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $97.72 / $281.84	Professional	26	$54.95	$97.72	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $245.47 / $691.83	Professional	TC	$89.13	$245.47	$691.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $234.42 / $323.59	Professional		$134.90	$234.42	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $102.33	Professional	26	$52.48	$61.66	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $169.82 / $245.47	Professional	TC	$79.43	$169.82	$245.47