Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $95.50 / $123.03	Facility	26	$67.61	$95.50	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $331.13	Professional		$131.83	$169.82	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $269.15	Professional	26	$54.95	$85.11	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $95.50 / $218.78	Professional	TC	$63.10	$95.50	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $131.83	Professional	26	$52.48	$72.44	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $138.04 / $323.59	Professional		$134.90	$138.04	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $61.66 / $102.33	Professional	26	$60.26	$61.66	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $75.86 / $239.88	Professional	TC	$74.13	$75.86	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $151.36	Professional		$53.70	$77.62	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $309.03 / $1,230.27	Professional		$138.04	$309.03	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $95.50 / $323.59	Professional	26	$56.23	$95.50	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $223.87 / $457.09	Professional	TC	$67.61	$223.87	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $309.03	Professional		$128.82	$181.97	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $107.15	Professional	26	$50.12	$66.07	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $107.15 / $239.88	Professional	TC	$66.07	$107.15	$239.88