Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.80 / $102.80 / $129.68	Facility	26	$102.80	$102.80	$129.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.22 / $147.04 / $260.72	Professional		$130.22	$147.04	$260.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $102.80 / $149.51	Professional	26	$93.33	$102.80	$149.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.69 / $32.90 / $110.68	Professional	TC	$28.69	$32.90	$110.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $119.76 / $134.72	Professional	26	$79.84	$119.76	$134.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.56 / $181.11 / $659.17	Professional		$141.56	$181.11	$659.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.53 / $117.10 / $164.16	Professional	26	$99.53	$117.10	$164.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.31 / $49.44 / $558.36	Professional	TC	$40.31	$49.44	$558.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.19 / $114.77 / $187.54	Professional		$38.19	$114.77	$187.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.68 / $442.64 / $1,059.50	Professional		$195.68	$442.64	$1,059.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.07 / $153.41 / $225.38	Professional	26	$103.07	$153.41	$225.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.16 / $249.06 / $728.39	Professional	TC	$41.16	$249.06	$728.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $146.31	Professional		$32.34	$32.34	$146.31
United Facility/Professional Professional Modifier Low / Median / High Price $122.50 / $192.89 / $491.82	Professional		$122.50	$192.89	$491.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.44 / $111.13 / $158.85	Professional	26	$95.44	$111.13	$158.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $42.72 / $384.18	Professional	TC	$22.01	$42.72	$384.18