Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.55 / $19.66 / $30.72	Facility	26	$17.55	$19.66	$30.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $89.92 / $178.24	Professional		$78.54	$89.92	$178.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.94 / $19.26 / $41.85	Professional	26	$17.94	$19.26	$41.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $70.25 / $112.49	Professional	TC	$55.57	$70.25	$112.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $72.56 / $72.56	Professional		$72.56	$72.56	$72.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $21.87 / $23.35	Professional	26	$14.92	$21.87	$23.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $74.56 / $112.86	Professional		$72.40	$74.56	$112.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $20.55 / $26.64	Professional	26	$18.64	$20.55	$26.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.46 / $54.03 / $83.38	Professional	TC	$52.46	$54.03	$83.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $29.89 / $131.44	Professional		$21.48	$29.89	$131.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.72 / $22.72 / $22.72	Facility	26	$22.72	$22.72	$22.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $113.42 / $167.61	Professional		$78.03	$113.42	$167.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $27.68 / $45.96	Professional	26	$19.53	$27.68	$45.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.02 / $86.01 / $130.01	Professional	TC	$60.02	$86.01	$130.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $62.35	Professional		$32.34	$32.34	$62.35
United Facility/Professional Professional Modifier Low / Median / High Price $73.31 / $92.05 / $134.12	Professional		$73.31	$92.05	$134.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $22.36 / $31.94	Professional	26	$18.82	$22.36	$31.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.96 / $69.95 / $100.03	Professional	TC	$53.96	$69.95	$100.03