Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.71 / $63.53 / $112.06	Facility	26	$58.71	$63.53	$112.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.09 / $303.77 / $769.62	Professional		$216.09	$303.77	$769.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $61.28 / $149.00	Professional	26	$58.24	$61.28	$149.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.38 / $248.90 / $451.28	Professional	TC	$157.38	$248.90	$451.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.15 / $173.82 / $179.72	Professional		$169.15	$173.82	$179.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.59 / $55.74 / $78.26	Professional	26	$44.59	$55.74	$78.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.00 / $257.45 / $379.78	Professional		$209.00	$257.45	$379.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $70.38 / $104.21	Professional	26	$59.82	$70.38	$104.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.18 / $192.23 / $277.85	Professional	TC	$149.18	$192.23	$277.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.77 / $170.65 / $286.01	Professional		$61.77	$170.65	$286.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.77 / $397.51 / $657.78	Professional		$255.77	$397.51	$657.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.89 / $89.83 / $143.97	Professional	26	$55.89	$89.83	$143.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.54 / $304.57 / $526.50	Professional	TC	$198.54	$304.57	$526.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $248.88	Professional		$32.34	$32.34	$248.88
United Facility/Professional Professional Modifier Low / Median / High Price $226.06 / $302.00 / $426.27	Professional		$226.06	$302.00	$426.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $66.36 / $97.98	Professional	26	$55.82	$66.36	$97.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.29 / $244.23 / $339.39	Professional	TC	$162.29	$244.23	$339.39