Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.39 / $26.33 / $46.99	Facility	26	$23.39	$26.33	$46.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $119.47 / $219.82	Professional		$97.57	$119.47	$219.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.39 / $25.68 / $41.22	Professional	26	$23.39	$25.68	$41.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $93.48 / $178.18	Professional	TC	$73.93	$93.48	$178.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.21 / $93.21 / $93.21	Professional		$93.21	$93.21	$93.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.49 / $29.18 / $29.76	Professional	26	$23.49	$29.18	$29.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $102.45 / $168.35	Professional		$87.08	$102.45	$168.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.22 / $29.68 / $45.04	Professional	26	$25.22	$29.68	$45.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.55 / $72.78 / $125.81	Professional	TC	$60.55	$72.78	$125.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $40.40 / $168.08	Professional		$28.61	$40.40	$168.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.35 / $146.97 / $239.40	Professional		$104.35	$146.97	$239.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $38.24 / $59.56	Professional	26	$25.85	$38.24	$59.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.58 / $112.46 / $176.40	Professional	TC	$76.58	$112.46	$176.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $83.54	Professional		$32.34	$32.34	$83.54
United Facility/Professional Professional Modifier Low / Median / High Price $94.20 / $111.77 / $168.34	Professional		$94.20	$111.77	$168.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $29.43 / $42.23	Professional	26	$23.81	$29.43	$42.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.73 / $89.82 / $131.87	Professional	TC	$69.73	$89.82	$131.87