Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $41.97 / $74.48	Facility	26	$39.14	$41.97	$74.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $178.59 / $399.63	Professional		$100.98	$178.59	$399.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $44.75 / $123.00	Professional	26	$37.36	$44.75	$123.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.83 / $128.80 / $263.31	Professional	TC	$61.83	$128.80	$263.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $81.06 / $86.07	Professional		$81.06	$81.06	$86.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $42.02 / $48.71	Professional	26	$29.89	$42.02	$48.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.57 / $143.05 / $304.50	Professional		$108.57	$143.05	$304.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.72 / $46.72 / $71.63	Professional	26	$39.72	$46.72	$71.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.86 / $84.24 / $240.00	Professional	TC	$68.86	$84.24	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $72.70 / $133.90	Professional		$42.98	$72.70	$133.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.92 / $45.92 / $45.92	Facility	26	$45.92	$45.92	$45.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.92 / $238.89 / $399.04	Professional		$126.92	$238.89	$399.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $60.05 / $101.90	Professional	26	$37.36	$60.05	$101.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $179.43 / $303.20	Professional	TC	$79.23	$179.43	$303.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $132.84	Professional		$32.34	$32.34	$132.84
United Facility/Professional Professional Modifier Low / Median / High Price $107.53 / $188.85 / $258.99	Professional		$107.53	$188.85	$258.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $43.67 / $64.59	Professional	26	$38.26	$43.67	$64.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.05 / $110.43 / $195.77	Professional	TC	$64.05	$110.43	$195.77