Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.25 / $33.89 / $54.42	Facility	26	$28.25	$33.89	$54.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.99 / $112.34 / $192.00	Professional		$89.99	$112.34	$192.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $29.67 / $60.22	Professional	26	$27.82	$29.67	$60.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.89 / $78.97 / $114.97	Professional	TC	$59.89	$78.97	$114.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.25 / $74.41 / $100.89	Professional		$61.25	$74.41	$100.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $25.62 / $45.57	Professional	26	$22.32	$25.62	$45.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.28 / $55.38 / $90.00	Professional	TC	$48.28	$55.38	$90.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.36 / $102.50 / $154.85	Professional		$86.36	$102.50	$154.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.20 / $31.34 / $48.70	Professional	26	$28.20	$31.34	$48.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.34 / $71.16 / $101.11	Professional	TC	$59.34	$71.16	$101.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.78 / $71.36 / $113.65	Professional		$29.78	$71.36	$113.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $129.80 / $208.20	Professional		$91.77	$129.80	$208.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $40.44 / $65.58	Professional	26	$28.64	$40.44	$65.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.34 / $83.45 / $143.81	Professional	TC	$59.34	$83.45	$143.81
United Facility/Professional Professional Modifier Low / Median / High Price $70.27 / $108.34 / $165.59	Professional		$70.27	$108.34	$165.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $32.83 / $57.46	Professional	26	$27.61	$32.83	$57.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.86 / $76.58 / $119.14	Professional	TC	$38.86	$76.58	$119.14