Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $112.26 / $152.18	Facility	26	$80.00	$112.26	$152.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.49 / $264.62 / $407.51	Professional		$215.49	$264.62	$407.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $83.16 / $148.00	Professional	26	$73.00	$83.16	$148.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.49 / $191.62 / $259.95	Professional	TC	$135.49	$191.62	$259.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $91.43 / $95.33	Professional	26	$40.00	$91.43	$95.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.80 / $275.95 / $402.17	Professional		$184.80	$275.95	$402.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.02 / $94.54 / $131.84	Professional	26	$80.02	$94.54	$131.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.50 / $181.42 / $267.58	Professional	TC	$121.50	$181.42	$267.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $122.02 / $285.52	Professional		$82.63	$122.02	$285.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.33 / $365.67 / $681.58	Professional		$211.33	$365.67	$681.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.77 / $117.03 / $193.24	Professional	26	$73.77	$117.03	$193.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.56 / $236.96 / $477.55	Professional	TC	$137.56	$236.96	$477.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $199.22	Professional		$32.34	$32.34	$199.22
United Facility/Professional Professional Modifier Low / Median / High Price $228.89 / $282.39 / $452.29	Professional		$228.89	$282.39	$452.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.05 / $90.91 / $133.16	Professional	26	$78.05	$90.91	$133.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.40 / $198.42 / $283.54	Professional	TC	$156.40	$198.42	$283.54