Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.28 / $64.75 / $78.38	Facility	26	$58.28	$64.75	$78.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $192.00 / $306.79	Professional		$113.36	$192.00	$306.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.85 / $64.75 / $119.78	Professional	26	$52.85	$64.75	$119.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.20 / $98.51 / $237.43	Professional	TC	$53.20	$98.51	$237.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.75 / $81.52 / $87.79	Professional	26	$53.75	$81.52	$87.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.29 / $169.67 / $709.83	Professional		$138.29	$169.67	$709.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.37 / $63.00 / $92.97	Professional	26	$52.37	$63.00	$92.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.15 / $105.95 / $661.03	Professional	TC	$77.15	$105.95	$661.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $75.88 / $147.46	Professional		$57.43	$75.88	$147.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.52 / $311.74 / $804.72	Professional		$129.52	$311.74	$804.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.81 / $87.52 / $130.05	Professional	26	$59.81	$87.52	$130.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.91 / $212.73 / $714.05	Professional	TC	$63.91	$212.73	$714.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $353.96	Professional		$32.34	$32.34	$353.96
United Facility/Professional Professional Modifier Low / Median / High Price $124.13 / $205.20 / $498.04	Professional		$124.13	$205.20	$498.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.32 / $66.40 / $106.06	Professional	26	$52.32	$66.40	$106.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.81 / $104.48 / $409.06	Professional	TC	$57.81	$104.48	$409.06