Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $40.74 / $58.88	Facility	26	$30.20	$40.74	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $302.00	Professional		$89.13	$141.25	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $48.98 / $128.82	Professional	26	$28.84	$48.98	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $85.11 / $165.96	Professional	TC	$60.26	$85.11	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $141.25	Professional		$66.07	$79.43	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $26.30 / $44.67	Professional	26	$23.99	$26.30	$44.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $52.48 / $102.33	Professional	TC	$43.65	$52.48	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $181.97	Professional		$97.72	$123.03	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $61.66	Professional	26	$31.62	$44.67	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $81.28 / $117.49	Professional	TC	$61.66	$81.28	$117.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $74.13 / $123.03	Professional		$33.11	$74.13	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $229.09	Professional		$89.13	$134.90	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $70.79	Professional	26	$26.92	$42.66	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $154.88	Professional	TC	$58.88	$89.13	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $173.78	Professional		$93.33	$114.82	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $36.31 / $56.23	Professional	26	$28.84	$36.31	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $79.43 / $120.23	Professional	TC	$60.26	$79.43	$120.23