Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.45 / $37.18 / $67.34	Facility	26	$33.45	$37.18	$67.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $114.17 / $289.69	Professional		$102.05	$114.17	$289.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $37.15 / $121.01	Professional	26	$31.76	$37.15	$121.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.22 / $77.37 / $143.43	Professional	TC	$69.22	$77.37	$143.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.36 / $33.57 / $44.46	Professional	26	$28.36	$33.57	$44.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.15 / $101.35 / $162.38	Professional		$86.15	$101.35	$162.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $37.82 / $59.21	Professional	26	$32.14	$37.82	$59.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.95 / $63.53 / $106.16	Professional	TC	$52.95	$63.53	$106.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.77 / $80.91 / $148.30	Professional		$40.77	$80.91	$148.30
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 $95.43 / $146.30 / $232.54	Professional		$95.43	$146.30	$232.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.31 / $51.84 / $76.80	Professional	26	$35.31	$51.84	$76.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.81 / $97.65 / $159.49	Professional	TC	$61.81	$97.65	$159.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $94.08	Professional		$32.34	$32.34	$94.08
United Facility/Professional Professional Modifier Low / Median / High Price $87.09 / $116.22 / $171.28	Professional		$87.09	$116.22	$171.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.92 / $41.50 / $61.32	Professional	26	$31.92	$41.50	$61.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.33 / $75.31 / $113.18	Professional	TC	$54.33	$75.31	$113.18