Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.90 / $75.42 / $102.24	Facility	26	$57.90	$75.42	$102.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.26 / $137.58 / $213.28	Professional		$113.26	$137.58	$213.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $59.73 / $101.62	Professional	26	$53.67	$59.73	$101.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.39 / $78.05 / $131.69	Professional	TC	$57.39	$78.05	$131.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.43 / $112.43 / $114.68	Professional		$112.43	$112.43	$114.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.00 / $73.13 / $78.75	Professional	26	$45.00	$73.13	$78.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.32 / $159.37 / $271.54	Professional		$133.32	$159.37	$271.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.67 / $69.03 / $96.39	Professional	26	$58.67	$69.03	$96.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $90.34 / $179.90	Professional	TC	$74.55	$90.34	$179.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $79.20 / $157.40	Professional		$61.80	$79.20	$157.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.78 / $68.78 / $68.78	Facility	26	$68.78	$68.78	$68.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.37 / $222.28 / $390.85	Professional		$153.37	$222.28	$390.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.76 / $91.25 / $138.47	Professional	26	$60.76	$91.25	$138.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.53 / $130.19 / $252.39	Professional	TC	$82.53	$130.19	$252.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $123.67	Professional		$32.34	$32.34	$123.67
United Facility/Professional Professional Modifier Low / Median / High Price $116.48 / $152.55 / $206.17	Professional		$116.48	$152.55	$206.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.30 / $70.65 / $90.03	Professional	26	$56.30	$70.65	$90.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.67 / $85.42 / $117.38	Professional	TC	$59.67	$85.42	$117.38