Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $128.82 / $194.98	Facility	26	$97.72	$128.82	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $354.81	Professional		$128.82	$151.36	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $120.23 / $239.88	Professional	26	$95.50	$120.23	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $100.00	Professional	TC	$25.70	$33.88	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $169.82	Professional	26	$79.43	$112.20	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $181.97 / $1,047.13	Professional		$162.18	$181.97	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $117.49 / $223.87	Professional	26	$109.65	$117.49	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $831.76	Professional	TC	$41.69	$48.98	$831.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $109.65 / $177.83	Professional		$39.81	$109.65	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $588.84 / $2,290.87	Professional		$204.17	$588.84	$2,290.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $199.53 / $724.44	Professional	26	$102.33	$199.53	$724.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $416.87 / $724.44	Professional	TC	$44.67	$416.87	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $151.36	Professional		$32.36	$33.11	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $512.86	Professional		$123.03	$213.80	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $165.96	Professional	26	$95.50	$112.20	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $50.12 / $398.11	Professional	TC	$21.88	$50.12	$398.11