Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.32 / $34.27 / $45.63	Facility	26	$33.32	$34.27	$45.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.15 / $106.41 / $219.47	Professional		$84.15	$106.41	$219.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $36.97 / $76.64	Professional	26	$32.13	$36.97	$76.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $56.82 / $91.60	Professional	TC	$48.35	$56.82	$91.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.17 / $88.55 / $129.18	Professional		$66.17	$88.55	$129.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $33.65 / $49.62	Professional	26	$26.46	$33.65	$49.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.46 / $64.73 / $77.56	Professional	TC	$45.46	$64.73	$77.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.34 / $96.60 / $149.72	Professional		$83.34	$96.60	$149.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.49 / $41.60 / $59.07	Professional	26	$34.49	$41.60	$59.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.26 / $55.00 / $85.25	Professional	TC	$50.26	$55.00	$85.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.19 / $60.31 / $105.35	Professional		$35.19	$60.31	$105.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $121.48 / $195.80	Professional		$87.29	$121.48	$195.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $47.30 / $78.14	Professional	26	$34.04	$47.30	$78.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $72.75 / $120.27	Professional	TC	$54.95	$72.75	$120.27
United Facility/Professional Professional Modifier Low / Median / High Price $82.82 / $99.18 / $171.76	Professional		$82.82	$99.18	$171.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $39.74 / $69.77	Professional	26	$33.08	$39.74	$69.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.44 / $61.41 / $104.48	Professional	TC	$50.44	$61.41	$104.48