Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $48.98 / $64.57	Facility	26	$40.74	$48.98	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $489.78	Professional		$109.65	$141.25	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $48.98 / $107.15	Professional	26	$30.90	$48.98	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $93.33 / $173.78	Professional	TC	$75.86	$93.33	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $79.43	Professional	26	$31.62	$44.67	$79.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $112.20 / $186.21	Professional		$102.33	$112.20	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $66.07	Professional	26	$36.31	$38.02	$66.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $75.86 / $125.89	Professional	TC	$64.57	$75.86	$125.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $91.20 / $162.18	Professional		$43.65	$91.20	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $47.86 / $69.18	Facility	26	$10.23	$47.86	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $162.18 / $630.96	Professional		$112.20	$162.18	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $60.26 / $194.98	Professional	26	$34.67	$60.26	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $134.90 / $436.52	Professional	TC	$74.13	$134.90	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $199.53	Professional		$95.50	$128.82	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $39.81 / $64.57	Professional	26	$31.62	$39.81	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $89.13 / $141.25	Professional	TC	$60.26	$89.13	$141.25