Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.79 / $62.94 / $80.13	Facility	26	$45.79	$62.94	$80.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.79 / $191.99 / $302.38	Professional		$172.79	$191.99	$302.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.79 / $50.51 / $79.41	Professional	26	$45.79	$50.51	$79.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.00 / $141.11 / $222.24	Professional	TC	$127.00	$141.11	$222.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.50 / $60.50 / $60.50	Professional	26	$60.50	$60.50	$60.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.66 / $172.66 / $234.45	Professional		$172.66	$172.66	$234.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $43.78 / $58.10	Professional	26	$43.78	$43.78	$58.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.87 / $128.87 / $174.99	Professional	TC	$128.87	$128.87	$174.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $67.76 / $96.80	Professional		$52.47	$67.76	$96.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.44 / $325.72 / $600.00	Professional		$190.44	$325.72	$600.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.70 / $78.27 / $124.97	Professional	26	$48.70	$78.27	$124.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.74 / $235.35 / $365.87	Professional	TC	$141.74	$235.35	$365.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $184.78	Professional		$32.34	$32.34	$184.78
United Facility/Professional Professional Modifier Low / Median / High Price $200.19 / $236.24 / $332.78	Professional		$200.19	$236.24	$332.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.75 / $59.68 / $85.53	Professional	26	$50.75	$59.68	$85.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.61 / $179.01 / $250.61	Professional	TC	$149.61	$179.01	$250.61