Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.53 / $35.53 / $59.32	Facility	26	$35.53	$35.53	$59.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.81 / $112.45 / $141.78	Professional		$96.81	$112.45	$141.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $36.44 / $71.26	Professional	26	$30.83	$36.44	$71.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.04 / $77.37 / $96.39	Professional	TC	$63.04	$77.37	$96.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.36 / $36.94 / $53.18	Professional	26	$28.36	$36.94	$53.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.67 / $100.77 / $156.19	Professional		$88.67	$100.77	$156.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.08 / $45.10 / $64.04	Professional	26	$36.08	$45.10	$64.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.95 / $55.67 / $88.72	Professional	TC	$52.95	$55.67	$88.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $84.89 / $142.05	Professional		$37.22	$84.89	$142.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $43.57 / $43.57	Facility	26	$43.57	$43.57	$43.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.72 / $133.08 / $252.17	Professional		$98.72	$133.08	$252.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $47.53 / $72.89	Professional	26	$33.31	$47.53	$72.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.71 / $86.18 / $175.32	Professional	TC	$61.71	$86.18	$175.32
United Facility/Professional Professional Modifier Low / Median / High Price $97.87 / $120.23 / $203.32	Professional		$97.87	$120.23	$203.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $41.50 / $67.51	Professional	26	$33.36	$41.50	$67.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.30 / $80.68 / $137.43	Professional	TC	$64.30	$80.68	$137.43