Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.52 / $59.94 / $86.48	Facility	26	$42.52	$59.94	$86.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.25 / $142.63 / $252.95	Professional		$112.25	$142.63	$252.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.68 / $47.26 / $75.34	Professional	26	$30.68	$47.26	$75.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $95.56 / $169.23	Professional	TC	$79.54	$95.56	$169.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $36.70 / $53.16	Professional	26	$36.24	$36.70	$53.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.45 / $127.62 / $199.78	Professional		$106.45	$127.62	$199.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $37.82 / $61.54	Professional	26	$32.14	$37.82	$61.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.55 / $91.26 / $136.22	Professional	TC	$69.55	$91.26	$136.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $72.51 / $195.98	Professional		$52.12	$72.51	$195.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $55.98	Facility	26	$55.98	$55.98	$55.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $181.21 / $301.52	Professional		$115.72	$181.21	$301.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.68 / $56.40 / $89.33	Professional	26	$36.68	$56.40	$89.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.26 / $130.65 / $237.20	Professional	TC	$76.26	$130.65	$237.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $120.54	Professional		$32.34	$32.34	$120.54
United Facility/Professional Professional Modifier Low / Median / High Price $103.80 / $148.99 / $217.93	Professional		$103.80	$148.99	$217.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.93 / $55.59 / $74.27	Professional	26	$31.93	$55.59	$74.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.65 / $107.71 / $145.01	Professional	TC	$70.65	$107.71	$145.01