Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.91 / $81.37 / $115.02	Facility	26	$61.91	$81.37	$115.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $256.27 / $1,169.00	Professional		$215.53	$256.27	$1,169.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.78 / $76.69 / $314.00	Professional	26	$62.78	$76.69	$314.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $166.43 / $291.83	Professional	TC	$152.75	$166.43	$291.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.02 / $66.02 / $70.34	Professional	26	$66.02	$66.02	$70.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.01 / $207.53 / $324.23	Professional		$173.01	$207.53	$324.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.42 / $68.73 / $98.23	Professional	26	$58.42	$68.73	$98.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.58 / $134.81 / $234.70	Professional	TC	$114.58	$134.81	$234.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.91 / $151.74 / $263.52	Professional		$61.91	$151.74	$263.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.50 / $69.50 / $69.50	Facility	26	$69.50	$69.50	$69.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.97 / $294.04 / $424.75	Professional		$205.97	$294.04	$424.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.08 / $92.06 / $139.78	Professional	26	$62.08	$92.06	$139.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.36 / $206.26 / $301.93	Professional	TC	$145.36	$206.26	$301.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $173.54	Professional		$32.34	$32.34	$173.54
United Facility/Professional Professional Modifier Low / Median / High Price $210.98 / $263.41 / $405.32	Professional		$210.98	$263.41	$405.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.57 / $85.71 / $120.79	Professional	26	$62.57	$85.71	$120.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.60 / $182.16 / $293.30	Professional	TC	$152.60	$182.16	$293.30