Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $14.31 / $25.63	Facility	26	$12.88	$14.31	$25.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.39 / $75.19 / $170.68	Professional		$54.39	$75.19	$170.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $17.26 / $29.13	Professional	26	$13.62	$17.26	$29.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.34 / $51.21 / $84.02	Professional	TC	$40.34	$51.21	$84.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.17 / $59.40 / $80.15	Professional		$44.17	$59.40	$80.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.88 / $13.60 / $17.80	Professional	26	$10.88	$13.60	$17.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $62.06 / $101.73	Professional		$52.24	$62.06	$101.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.41 / $18.82 / $29.14	Professional	26	$15.41	$18.82	$29.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.88 / $43.39 / $72.58	Professional	TC	$36.88	$43.39	$72.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.64 / $45.69 / $74.80	Professional		$15.64	$45.69	$74.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $86.75 / $129.69	Professional		$58.80	$86.75	$129.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $23.83 / $36.07	Professional	26	$16.61	$23.83	$36.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.13 / $62.56 / $90.86	Professional	TC	$42.13	$62.56	$90.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $49.52	Professional		$32.34	$32.34	$49.52
United Facility/Professional Professional Modifier Low / Median / High Price $52.43 / $66.09 / $106.70	Professional		$52.43	$66.09	$106.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $18.36 / $25.01	Professional	26	$15.52	$18.36	$25.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.14 / $47.85 / $67.30	Professional	TC	$37.14	$47.85	$67.30