Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.88 / $32.92 / $55.50	Facility	26	$28.88	$32.92	$55.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.78 / $93.45 / $168.00	Professional		$73.78	$93.45	$168.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $32.07 / $66.78	Professional	26	$27.64	$32.07	$66.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.72 / $52.36 / $86.65	Professional	TC	$42.72	$52.36	$86.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.34 / $82.04 / $109.88	Professional		$58.34	$82.04	$109.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.92 / $32.95 / $42.98	Professional	26	$22.92	$32.95	$42.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.33 / $47.45 / $66.89	Professional	TC	$40.33	$47.45	$66.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $94.10 / $145.85	Professional		$75.28	$94.10	$145.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.25 / $42.90 / $59.45	Professional	26	$34.25	$42.90	$59.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.59 / $51.20 / $79.40	Professional	TC	$44.59	$51.20	$79.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $53.20 / $92.66	Professional		$30.08	$53.20	$92.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.11 / $35.11 / $35.11	Facility	26	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.69 / $109.39 / $184.08	Professional		$77.69	$109.39	$184.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.04 / $40.90 / $68.06	Professional	26	$30.04	$40.90	$68.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.29 / $66.93 / $116.01	Professional	TC	$49.29	$66.93	$116.01
United Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $87.95 / $150.06	Professional		$72.95	$87.95	$150.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $33.77 / $58.73	Professional	26	$28.22	$33.77	$58.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $54.56 / $93.23	Professional	TC	$44.67	$54.56	$93.23