Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.98 / $94.93 / $128.68	Facility	26	$67.98	$94.93	$128.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.88 / $152.49 / $276.52	Professional		$131.88	$152.49	$276.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $70.31 / $222.00	Professional	26	$52.54	$70.31	$222.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.90 / $91.19 / $212.80	Professional	TC	$63.90	$91.19	$212.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.27 / $55.37 / $80.63	Professional	26	$51.27	$55.37	$80.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $150.03 / $327.30	Professional		$132.44	$150.03	$327.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $62.35 / $98.87	Professional	26	$55.84	$62.35	$98.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.81 / $84.41 / $240.00	Professional	TC	$69.81	$84.41	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $80.63 / $158.62	Professional		$56.12	$80.63	$158.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.47 / $242.95 / $439.19	Professional		$138.47	$242.95	$439.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.46 / $80.55 / $129.41	Professional	26	$56.46	$80.55	$129.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $141.75 / $339.10	Professional	TC	$67.81	$141.75	$339.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $147.29	Professional		$32.34	$32.34	$147.29
United Facility/Professional Professional Modifier Low / Median / High Price $134.65 / $181.19 / $289.07	Professional		$134.65	$181.19	$289.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $65.59 / $109.34	Professional	26	$50.67	$65.59	$109.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $101.34 / $231.41	Professional	TC	$67.81	$101.34	$231.41