Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.76 / $32.29 / $57.24	Facility	26	$28.76	$32.29	$57.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.47 / $131.97 / $574.00	Professional		$91.47	$131.97	$574.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $42.52 / $135.00	Professional	26	$29.75	$42.52	$135.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.85 / $83.28 / $151.35	Professional	TC	$58.85	$83.28	$151.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.37 / $95.25 / $128.63	Professional		$68.37	$95.25	$128.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $28.57 / $39.39	Professional	26	$24.20	$28.57	$39.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.22 / $71.20 / $80.05	Professional	TC	$51.22	$71.20	$80.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $116.80 / $156.46	Professional		$95.42	$116.80	$156.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $35.94 / $53.53	Professional	26	$31.34	$35.94	$53.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.34 / $81.75 / $106.51	Professional	TC	$59.34	$81.75	$106.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $70.81 / $128.63	Professional		$33.33	$70.81	$128.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.21 / $142.66 / $234.73	Professional		$92.21	$142.66	$234.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $45.43 / $76.91	Professional	26	$29.10	$45.43	$76.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.81 / $95.06 / $151.85	Professional	TC	$58.81	$95.06	$151.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $119.44	Professional		$32.34	$32.34	$119.44
United Facility/Professional Professional Modifier Low / Median / High Price $90.75 / $113.32 / $161.63	Professional		$90.75	$113.32	$161.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $36.67 / $58.99	Professional	26	$30.31	$36.67	$58.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.91 / $79.55 / $104.19	Professional	TC	$58.91	$79.55	$104.19