Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.01 / $45.17 / $58.72	Facility	26	$44.01	$45.17	$58.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.94 / $153.69 / $278.75	Professional		$134.94	$153.69	$278.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.11 / $49.63 / $83.26	Professional	26	$45.11	$49.63	$83.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.78 / $106.59 / $173.76	Professional	TC	$89.78	$106.59	$173.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.01 / $56.01 / $56.01	Professional	26	$56.01	$56.01	$56.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $143.75 / $245.50	Professional		$101.12	$143.75	$245.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $48.81 / $75.50	Professional	26	$41.48	$48.81	$75.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.63 / $95.76 / $178.60	Professional	TC	$59.63	$95.76	$178.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $66.02 / $175.15	Professional		$44.21	$66.02	$175.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.78 / $211.70 / $325.81	Professional		$130.78	$211.70	$325.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $68.12 / $99.75	Professional	26	$43.88	$68.12	$99.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.87 / $144.28 / $237.00	Professional	TC	$89.87	$144.28	$237.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $154.19	Professional		$32.34	$32.34	$154.19
United Facility/Professional Professional Modifier Low / Median / High Price $129.91 / $201.48 / $292.39	Professional		$129.91	$201.48	$292.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.26 / $59.82 / $83.01	Professional	26	$44.26	$59.82	$83.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.07 / $136.02 / $192.26	Professional	TC	$85.07	$136.02	$192.26