Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.56 / $65.59 / $118.03	Facility	26	$54.56	$65.59	$118.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.65 / $451.62 / $749.38	Professional		$374.65	$451.62	$749.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $64.50 / $116.82	Professional	26	$54.56	$64.50	$116.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $320.08 / $384.84 / $592.14	Professional	TC	$320.08	$384.84	$592.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $378.29 / $378.29 / $378.29	Professional		$378.29	$378.29	$378.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $68.22	Professional	26	$52.48	$52.48	$68.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.01 / $390.66 / $660.62	Professional		$318.01	$390.66	$660.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.16 / $60.45 / $97.93	Professional	26	$49.16	$60.45	$97.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.85 / $316.30 / $564.48	Professional	TC	$268.85	$316.30	$564.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $74.06 / $548.86	Professional		$56.84	$74.06	$548.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $64.81 / $64.81	Facility	26	$64.81	$64.81	$64.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.63 / $592.72 / $970.13	Professional		$398.63	$592.72	$970.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.16 / $100.13 / $169.00	Professional	26	$61.16	$100.13	$169.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $341.58 / $503.41 / $817.76	Professional	TC	$341.58	$503.41	$817.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $71.89 / $222.44	Professional		$32.34	$71.89	$222.44
United Facility/Professional Professional Modifier Low / Median / High Price $374.56 / $555.73 / $805.30	Professional		$374.56	$555.73	$805.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.36 / $89.04 / $133.83	Professional	26	$58.36	$89.04	$133.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $289.58 / $420.90 / $677.57	Professional	TC	$289.58	$420.90	$677.57