Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.24 / $39.15 / $73.16	Facility	26	$35.24	$39.15	$73.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.43 / $135.47 / $598.97	Professional		$93.43	$135.47	$598.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $51.45 / $219.00	Professional	26	$36.61	$51.45	$219.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.65 / $64.31 / $118.51	Professional	TC	$55.65	$64.31	$118.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.67 / $105.65 / $133.85	Professional		$78.67	$105.65	$133.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $43.92 / $52.43	Professional	26	$33.60	$43.92	$52.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.27 / $75.62 / $78.53	Professional	TC	$64.27	$75.62	$78.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.68 / $84.33 / $148.56	Professional		$71.68	$84.33	$148.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.81 / $35.07 / $61.91	Professional	26	$29.81	$35.07	$61.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.87 / $49.26 / $90.19	Professional	TC	$41.87	$49.26	$90.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $66.90 / $130.88	Professional		$40.54	$66.90	$130.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.97 / $134.57 / $226.57	Professional		$88.97	$134.57	$226.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.03 / $54.96 / $88.65	Professional	26	$36.03	$54.96	$88.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.19 / $79.68 / $145.50	Professional	TC	$48.19	$79.68	$145.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $124.29	Professional		$32.34	$32.34	$124.29
United Facility/Professional Professional Modifier Low / Median / High Price $86.71 / $108.16 / $156.62	Professional		$86.71	$108.16	$156.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.49 / $45.48 / $61.56	Professional	26	$37.49	$45.48	$61.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.78 / $67.39 / $94.13	Professional	TC	$48.78	$67.39	$94.13