Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $52.48 / $74.13	Facility	26	$38.90	$52.48	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $173.78 / $524.81	Professional		$93.33	$173.78	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $67.61 / $213.80	Professional	26	$36.31	$67.61	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $72.44 / $151.36	Professional	TC	$54.95	$72.44	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $194.98	Professional		$70.79	$100.00	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $41.69 / $77.62	Professional	26	$30.20	$41.69	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $61.66 / $128.82	Professional	TC	$51.29	$61.66	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $85.11 / $147.91	Professional		$81.28	$85.11	$147.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $34.67 / $60.26	Professional	26	$33.88	$34.67	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $48.98 / $87.10	Professional	TC	$45.71	$48.98	$87.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $123.03	Professional		$40.74	$66.07	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $66.07	Facility	26	$9.77	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $501.19	Professional		$87.10	$134.90	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $61.66 / $186.21	Professional	26	$37.15	$61.66	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $95.50 / $316.23	Professional	TC	$47.86	$95.50	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $83.18	Professional		$32.36	$33.11	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $173.78	Professional		$85.11	$112.20	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $43.65 / $67.61	Professional	26	$37.15	$43.65	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $67.61 / $109.65	Professional	TC	$43.65	$67.61	$109.65