Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $61.66 / $61.66	Facility	26	$58.88	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $478.63	Professional		$204.17	$239.88	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $85.11	Professional	26	$56.23	$63.10	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $169.82 / $316.23	Professional	TC	$144.54	$169.82	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $173.78	Professional		$162.18	$162.18	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $512.86	Professional		$213.80	$251.19	$512.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $54.95 / $114.82	Professional	26	$47.86	$54.95	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $190.55 / $457.09	Professional	TC	$165.96	$190.55	$457.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $93.33	Professional		$51.29	$75.86	$93.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $100.00	Facility	26	$14.79	$69.18	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $794.33 / $2,187.76	Professional		$302.00	$794.33	$2,187.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $112.20 / $288.40	Professional	26	$63.10	$112.20	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $707.95 / $1,995.26	Professional	TC	$213.80	$707.95	$1,995.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $630.96	Professional		$204.17	$416.87	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $104.71	Professional	26	$53.70	$64.57	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $323.59 / $549.54	Professional	TC	$144.54	$323.59	$549.54