Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.34 / $36.27 / $65.06	Facility	26	$32.34	$36.27	$65.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.54 / $277.49 / $417.56	Professional		$248.54	$277.49	$417.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.34 / $35.56 / $57.35	Professional	26	$32.34	$35.56	$57.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.19 / $241.93 / $366.18	Professional	TC	$216.19	$241.93	$366.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.39 / $27.52 / $44.71	Professional	26	$27.39	$27.52	$44.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.88 / $231.42 / $366.91	Professional		$196.88	$231.42	$366.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.63 / $41.58 / $53.48	Professional	26	$35.63	$41.58	$53.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.88 / $190.08 / $307.39	Professional	TC	$157.88	$190.08	$307.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $229.46 / $364.25	Professional		$39.54	$229.46	$364.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $42.12 / $42.12	Facility	26	$42.12	$42.12	$42.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.47 / $408.70 / $1,384.50	Professional		$232.47	$408.70	$1,384.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.52 / $62.59 / $179.94	Professional	26	$37.52	$62.59	$179.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.39 / $342.55 / $1,213.00	Professional	TC	$188.39	$342.55	$1,213.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $280.67	Professional		$32.34	$32.34	$280.67
United Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $285.16 / $426.44	Professional		$197.99	$285.16	$426.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $43.54 / $57.35	Professional	26	$34.15	$43.54	$57.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.02 / $303.87 / $372.76	Professional	TC	$162.02	$303.87	$372.76