Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $37.15 / $51.29	Facility	26	$25.70	$37.15	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $199.53	Professional		$89.13	$120.23	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $77.62	Professional	26	$22.91	$28.18	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $91.20 / $158.49	Professional	TC	$70.79	$91.20	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $36.31	Professional	26	$30.20	$30.20	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $181.97	Professional		$93.33	$97.72	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.90 / $52.48	Professional	26	$30.20	$30.90	$52.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $66.07 / $131.83	Professional	TC	$64.57	$66.07	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $40.74	Professional		$25.70	$34.67	$40.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $154.88 / $588.84	Professional		$93.33	$154.88	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $46.77 / $131.83	Professional	26	$26.92	$46.77	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $128.82 / $457.09	Professional	TC	$70.79	$128.82	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $79.43	Professional		$32.36	$33.11	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $109.65 / $177.83	Professional		$91.20	$109.65	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.20 / $45.71	Professional	26	$25.12	$30.20	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $79.43 / $128.82	Professional	TC	$64.57	$79.43	$128.82