Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.00 / $50.63 / $50.63	Facility	26	$48.00	$50.63	$50.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.62 / $287.73 / $309.43	Professional		$189.62	$287.73	$309.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.35 / $49.82 / $65.18	Professional	26	$43.35	$49.82	$65.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.25 / $240.75 / $258.02	Professional	TC	$133.25	$240.75	$258.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.45 / $40.45 / $40.45	Professional	26	$40.45	$40.45	$40.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.13 / $156.13 / $202.44	Professional		$156.13	$156.13	$202.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $26.78 / $66.43	Professional	26	$26.78	$26.78	$66.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.36 / $129.84 / $140.26	Professional	TC	$129.36	$129.84	$140.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.77 / $327.99 / $469.76	Professional		$69.77	$327.99	$469.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $243.03 / $243.03 / $243.03	Facility	26	$243.03	$243.03	$243.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.22 / $230.43 / $543.69	Professional		$101.22	$230.43	$543.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $59.75 / $117.10	Professional	26	$29.65	$59.75	$117.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.02 / $164.45 / $450.74	Professional	TC	$69.02	$164.45	$450.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $192.44 / $363.96 / $586.64	Professional		$192.44	$363.96	$586.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.49 / $67.31 / $126.28	Professional	26	$40.49	$67.31	$126.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.32 / $300.88 / $595.74	Professional	TC	$134.32	$300.88	$595.74