Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $75.86 / $107.15	Facility	26	$56.23	$75.86	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $263.03	Professional		$112.20	$134.90	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $102.33 / $776.25	Professional	26	$56.23	$102.33	$776.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $67.61 / $131.83	Professional	TC	$57.54	$67.61	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $95.50	Professional		$91.20	$91.20	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $120.23	Professional	26	$47.86	$63.10	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $158.49 / $371.54	Professional		$144.54	$158.49	$371.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $69.18 / $125.89	Professional	26	$64.57	$69.18	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $91.20 / $251.19	Professional	TC	$77.62	$91.20	$251.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $79.43 / $151.36	Professional		$61.66	$79.43	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $97.72	Facility	26	$14.79	$69.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $281.84 / $831.76	Professional		$158.49	$281.84	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $112.20 / $295.12	Professional	26	$60.26	$112.20	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $169.82 / $316.23	Professional	TC	$89.13	$169.82	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $223.87	Professional		$114.82	$158.49	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $66.07 / $97.72	Professional	26	$56.23	$66.07	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $93.33 / $123.03	Professional	TC	$57.54	$93.33	$123.03