Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.76 / $37.67 / $60.47	Facility	26	$28.76	$37.67	$60.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.40 / $193.87 / $355.50	Professional		$182.40	$193.87	$355.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $36.65 / $67.08	Professional	26	$23.61	$36.65	$67.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.72 / $162.49 / $275.93	Professional	TC	$144.72	$162.49	$275.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.68 / $170.68 / $170.68	Professional		$170.68	$170.68	$170.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.47 / $65.47 / $65.47	Professional	26	$65.47	$65.47	$65.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.07 / $172.70 / $268.08	Professional		$131.07	$172.70	$268.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.46 / $24.01 / $51.17	Professional	26	$18.46	$24.01	$51.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.60 / $146.01 / $231.16	Professional	TC	$112.60	$146.01	$231.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $56.06 / $251.72	Professional		$39.59	$56.06	$251.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $43.28	Facility	26	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.54 / $265.76 / $450.99	Professional		$179.54	$265.76	$450.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.71 / $39.17 / $77.11	Professional	26	$26.71	$39.17	$77.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.32 / $223.49 / $393.89	Professional	TC	$150.32	$223.49	$393.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $142.51	Professional		$32.34	$32.34	$142.51
United Facility/Professional Professional Modifier Low / Median / High Price $183.05 / $256.41 / $391.00	Professional		$183.05	$256.41	$391.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $34.70 / $79.84	Professional	26	$22.28	$34.70	$79.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.30 / $210.82 / $306.95	Professional	TC	$148.30	$210.82	$306.95