Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.89 / $31.29 / $45.93	Facility	26	$22.89	$31.29	$45.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $98.83 / $243.40	Professional		$86.06	$98.83	$243.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.92 / $25.78 / $50.88	Professional	26	$23.92	$25.78	$50.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $71.89 / $132.99	Professional	TC	$61.40	$71.89	$132.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.51 / $22.73 / $30.09	Professional	26	$19.51	$22.73	$30.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $89.64 / $89.64 / $89.64	Professional	TC	$89.64	$89.64	$89.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.97 / $85.97 / $116.73	Professional		$85.97	$85.97	$116.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.54 / $27.21 / $33.77	Professional	26	$24.54	$27.21	$33.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.77 / $58.77 / $83.17	Professional	TC	$58.77	$58.77	$83.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.32 / $79.29 / $130.21	Professional		$26.32	$79.29	$130.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $122.94 / $204.56	Professional		$86.94	$122.94	$204.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $36.86 / $62.49	Professional	26	$23.09	$36.86	$62.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.56 / $87.91 / $152.61	Professional	TC	$62.56	$87.91	$152.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $73.92	Professional		$32.34	$32.34	$73.92
United Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $111.00 / $155.52	Professional		$85.53	$111.00	$155.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.35 / $29.11 / $40.58	Professional	26	$24.35	$29.11	$40.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.03 / $77.31 / $111.65	Professional	TC	$57.03	$77.31	$111.65