Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.06 / $64.28 / $98.91	Facility	26	$55.06	$64.28	$98.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.39 / $362.96 / $707.97	Professional		$289.39	$362.96	$707.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $57.46 / $221.87	Professional	26	$51.54	$57.46	$221.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $304.10 / $562.58	Professional	TC	$251.27	$304.10	$562.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $323.77 / $375.46 / $522.21	Professional		$323.77	$375.46	$522.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $66.86 / $72.00	Professional	26	$52.18	$66.86	$72.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.41 / $303.16 / $442.42	Professional		$178.41	$303.16	$442.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.64 / $57.72 / $84.31	Professional	26	$47.64	$57.72	$84.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.12 / $226.00 / $380.06	Professional	TC	$107.12	$226.00	$380.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.57 / $324.98 / $467.63	Professional		$56.57	$324.98	$467.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.04 / $368.23 / $640.40	Professional		$201.04	$368.23	$640.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.00 / $74.48 / $115.30	Professional	26	$52.00	$74.48	$115.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.88 / $297.25 / $552.44	Professional	TC	$140.88	$297.25	$552.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.27 / $179.98	Professional		$32.34	$41.27	$179.98
United Facility/Professional Professional Modifier Low / Median / High Price $193.53 / $345.80 / $687.66	Professional		$193.53	$345.80	$687.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.79 / $67.92 / $115.42	Professional	26	$47.79	$67.92	$115.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.88 / $273.82 / $563.66	Professional	TC	$140.88	$273.82	$563.66