Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $66.07 / $117.49	Facility	26	$64.57	$66.07	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $263.03	Professional		$107.15	$154.88	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $131.83	Professional	26	$50.12	$69.18	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $67.61 / $186.21	Professional	TC	$48.98	$67.61	$186.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $66.07 / $89.13	Professional	26	$48.98	$66.07	$89.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $165.96 / $776.25	Professional		$162.18	$165.96	$776.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $63.10 / $109.65	Professional	26	$60.26	$63.10	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $107.15 / $691.83	Professional	TC	$89.13	$107.15	$691.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $83.18	Professional		$42.66	$67.61	$83.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $77.62 / $109.65	Facility	26	$16.60	$77.62	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $407.38 / $2,344.23	Professional		$128.82	$407.38	$2,344.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $100.00 / $309.03	Professional	26	$56.23	$100.00	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $323.59 / $812.83	Professional	TC	$64.57	$323.59	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $354.81	Professional		$32.36	$33.11	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $524.81	Professional		$123.03	$213.80	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $104.71	Professional	26	$52.48	$64.57	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $131.83 / $457.09	Professional	TC	$60.26	$131.83	$457.09