Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.53 / $36.53 / $36.53	Facility	26	$36.53	$36.53	$36.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.55 / $92.40 / $400.67	Professional		$70.55	$92.40	$400.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.17 / $38.33 / $168.35	Professional	26	$36.17	$38.33	$168.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $49.65 / $104.85	Professional	TC	$34.02	$49.65	$104.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.12 / $58.12 / $59.94	Professional		$58.12	$58.12	$59.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $43.70 / $48.94	Professional	26	$27.86	$43.70	$48.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.42 / $52.87 / $245.23	Professional		$44.42	$52.87	$245.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $22.75 / $65.51	Professional	26	$19.12	$22.75	$65.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $28.73 / $182.90	Professional	TC	$23.56	$28.73	$182.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.77 / $49.29 / $99.02	Professional		$35.77	$49.29	$99.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $137.72 / $256.20	Professional		$71.78	$137.72	$256.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.94 / $56.05 / $87.89	Professional	26	$37.94	$56.05	$87.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $79.53 / $188.40	Professional	TC	$36.97	$79.53	$188.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $99.37	Professional		$32.34	$32.34	$99.37
United Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $94.78 / $165.52	Professional		$64.84	$94.78	$165.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $41.74 / $60.28	Professional	26	$35.47	$41.74	$60.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.37 / $51.24 / $117.33	Professional	TC	$28.37	$51.24	$117.33