Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.07 / $39.07 / $50.87	Facility	26	$29.07	$39.07	$50.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $105.10 / $191.83	Professional		$96.85	$105.10	$191.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $32.52 / $51.21	Professional	26	$30.58	$32.52	$51.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.25 / $70.11 / $110.42	Professional	TC	$64.25	$70.11	$110.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.58 / $34.01 / $50.15	Professional	26	$24.58	$34.01	$50.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.42 / $81.81 / $118.36	Professional		$79.42	$81.81	$118.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.18 / $28.00 / $36.58	Professional	26	$27.18	$28.00	$36.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.24 / $53.81 / $82.32	Professional	TC	$52.24	$53.81	$82.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $73.42 / $132.66	Professional		$35.56	$73.42	$132.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.22 / $142.47 / $227.52	Professional		$98.22	$142.47	$227.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $49.13 / $78.48	Professional	26	$33.22	$49.13	$78.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $95.76 / $149.03	Professional	TC	$67.45	$95.76	$149.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $84.88	Professional		$32.34	$32.34	$84.88
United Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $110.43 / $165.65	Professional		$92.35	$110.43	$165.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.42 / $39.14 / $54.02	Professional	26	$31.42	$39.14	$54.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.00 / $74.70 / $104.58	Professional	TC	$62.00	$74.70	$104.58