Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.11 / $62.50 / $82.80	Facility	26	$41.11	$62.50	$82.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.27 / $142.88 / $625.00	Professional		$103.27	$142.88	$625.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $49.64 / $198.00	Professional	26	$42.60	$49.64	$198.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.98 / $74.87 / $131.31	Professional	TC	$56.98	$74.87	$131.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $113.82 / $144.19	Professional		$84.56	$113.82	$144.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $48.40 / $61.18	Professional	26	$34.95	$48.40	$61.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.35 / $77.09 / $81.62	Professional	TC	$49.35	$77.09	$81.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.86 / $131.60 / $184.10	Professional		$111.86	$131.60	$184.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.32 / $54.50 / $77.25	Professional	26	$46.32	$54.50	$77.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.54 / $77.11 / $118.53	Professional	TC	$65.54	$77.11	$118.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.06 / $71.16 / $137.63	Professional		$48.06	$71.16	$137.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.62 / $53.62 / $53.62	Facility	26	$53.62	$53.62	$53.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.87 / $161.66 / $243.73	Professional		$106.87	$161.66	$243.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $65.48 / $100.94	Professional	26	$44.68	$65.48	$100.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.19 / $91.93 / $149.27	Professional	TC	$62.19	$91.93	$149.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $133.90	Professional		$32.34	$32.34	$133.90
United Facility/Professional Professional Modifier Low / Median / High Price $103.34 / $128.15 / $174.31	Professional		$103.34	$128.15	$174.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $51.65 / $73.31	Professional	26	$43.99	$51.65	$73.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.90 / $76.27 / $102.25	Professional	TC	$57.90	$76.27	$102.25