Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.91 / $74.06 / $132.97	Facility	26	$65.91	$74.06	$132.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.88 / $400.02 / $695.07	Professional		$365.88	$400.02	$695.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.62 / $73.23 / $146.66	Professional	26	$67.62	$73.23	$146.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $289.41 / $326.62 / $594.90	Professional	TC	$289.41	$326.62	$594.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $311.61 / $311.61 / $365.16	Professional		$311.61	$311.61	$365.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.76 / $81.98 / $97.66	Professional	26	$69.76	$81.98	$97.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $254.17 / $254.17 / $254.17	Professional	TC	$254.17	$254.17	$254.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.62 / $400.84 / $584.19	Professional		$332.62	$400.84	$584.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.95 / $79.06 / $106.18	Professional	26	$64.95	$79.06	$106.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $258.43 / $324.43 / $481.04	Professional	TC	$258.43	$324.43	$481.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.22 / $295.39 / $511.22	Professional		$80.22	$295.39	$511.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $387.45 / $693.44 / $1,970.71	Professional		$387.45	$693.44	$1,970.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.54 / $127.08 / $347.67	Professional	26	$81.54	$127.08	$347.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $314.20 / $575.83 / $1,623.04	Professional	TC	$314.20	$575.83	$1,623.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $401.68	Professional		$32.34	$32.34	$401.68
United Facility/Professional Professional Modifier Low / Median / High Price $443.86 / $572.60 / $689.16	Professional		$443.86	$572.60	$689.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.15 / $138.06	Professional	26	$74.13	$100.15	$138.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $389.32 / $453.36 / $543.33	Professional	TC	$389.32	$453.36	$543.33