Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.65 / $38.50 / $75.23	Facility	26	$37.65	$38.50	$75.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $219.03 / $808.75	Professional		$133.66	$219.03	$808.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $58.00 / $121.12	Professional	26	$36.54	$58.00	$121.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $151.46 / $250.91	Professional	TC	$96.29	$151.46	$250.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.68 / $163.66 / $192.56	Professional		$113.68	$163.66	$192.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $30.91 / $43.75	Professional	26	$27.88	$30.91	$43.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.17 / $103.17 / $128.26	Professional	TC	$103.17	$103.17	$128.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.69 / $189.05 / $265.80	Professional		$160.69	$189.05	$265.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $56.57 / $81.94	Professional	26	$44.02	$56.57	$81.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.60 / $132.47 / $183.87	Professional	TC	$112.60	$132.47	$183.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $117.81 / $192.42	Professional		$38.35	$117.81	$192.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.03 / $238.67 / $391.84	Professional		$149.03	$238.67	$391.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.69 / $69.47 / $114.29	Professional	26	$37.69	$69.47	$114.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.52 / $169.16 / $283.12	Professional	TC	$112.52	$169.16	$283.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $137.48	Professional		$32.34	$32.34	$137.48
United Facility/Professional Professional Modifier Low / Median / High Price $156.01 / $215.00 / $307.23	Professional		$156.01	$215.00	$307.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.61 / $59.64 / $84.64	Professional	26	$39.61	$59.64	$84.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.01 / $157.71 / $228.52	Professional	TC	$111.01	$157.71	$228.52