Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $30.01 / $53.08	Facility	26	$26.70	$30.01	$53.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.89 / $126.04 / $605.00	Professional		$84.89	$126.04	$605.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $42.36 / $126.44	Professional	26	$27.82	$42.36	$126.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.71 / $84.53 / $136.65	Professional	TC	$56.71	$84.53	$136.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $76.56 / $131.13	Professional		$65.11	$76.56	$131.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $25.85 / $45.57	Professional	26	$22.43	$25.85	$45.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.42 / $50.42 / $63.46	Professional	TC	$50.42	$50.42	$63.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.36 / $113.14 / $134.66	Professional		$86.36	$113.14	$134.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.36 / $32.63 / $49.72	Professional	26	$28.36	$32.63	$49.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.15 / $83.53 / $96.36	Professional	TC	$51.15	$83.53	$96.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.92 / $68.20 / $121.70	Professional		$30.92	$68.20	$121.70
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 $88.42 / $124.26 / $210.46	Professional		$88.42	$124.26	$210.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $42.55 / $71.41	Professional	26	$26.99	$42.55	$71.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.18 / $83.89 / $154.04	Professional	TC	$47.18	$83.89	$154.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $71.60	Professional		$32.34	$32.34	$71.60
United Facility/Professional Professional Modifier Low / Median / High Price $86.58 / $110.29 / $144.30	Professional		$86.58	$110.29	$144.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.12 / $34.63 / $46.86	Professional	26	$28.12	$34.63	$46.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.65 / $77.05 / $97.44	Professional	TC	$55.65	$77.05	$97.44