Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.03 / $88.78 / $137.32	Facility	26	$77.03	$88.78	$137.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.63 / $151.37 / $486.00	Professional		$126.63	$151.37	$486.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $82.73 / $155.49	Professional	26	$72.04	$82.73	$155.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.59 / $61.75 / $98.80	Professional	TC	$51.59	$61.75	$98.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $154.26 / $182.01	Professional		$112.84	$154.26	$182.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.27 / $93.39 / $100.58	Professional	26	$72.27	$93.39	$100.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.02 / $128.01 / $179.20	Professional		$107.02	$128.01	$179.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.37 / $73.98 / $102.80	Professional	26	$59.37	$73.98	$102.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.92 / $54.03 / $75.09	Professional	TC	$45.92	$54.03	$75.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $83.11 / $166.12	Professional		$51.50	$83.11	$166.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.73 / $88.73 / $88.73	Facility	26	$88.73	$88.73	$88.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.58 / $187.58 / $290.72	Professional		$123.58	$187.58	$290.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.69 / $106.27 / $168.02	Professional	26	$73.69	$106.27	$168.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.64 / $81.76 / $122.70	Professional	TC	$49.64	$81.76	$122.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.42 / $114.76	Professional		$32.34	$47.42	$114.76
United Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $175.30 / $280.13	Professional		$132.91	$175.30	$280.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $95.46 / $159.25	Professional	26	$74.70	$95.46	$159.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.56 / $70.98 / $120.17	Professional	TC	$56.56	$70.98	$120.17