Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.96 / $31.07 / $42.93	Facility	26	$27.96	$31.07	$42.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.83 / $136.25 / $431.11	Professional		$111.83	$136.25	$431.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.60 / $33.07 / $123.76	Professional	26	$29.60	$33.07	$123.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.87 / $97.08 / $187.80	Professional	TC	$83.87	$97.08	$187.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.52 / $140.61 / $184.59	Professional		$125.52	$140.61	$184.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.18 / $31.88 / $42.00	Professional	26	$24.18	$31.88	$42.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $105.70 / $179.67	Professional		$66.84	$105.70	$179.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.09 / $35.65 / $52.90	Professional	26	$30.09	$35.65	$52.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.22 / $71.31 / $120.21	Professional	TC	$35.22	$71.31	$120.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $160.86 / $237.83	Professional		$33.00	$160.86	$237.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.75 / $161.62 / $343.74	Professional		$113.75	$161.62	$343.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.87 / $46.37 / $74.72	Professional	26	$30.87	$46.37	$74.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.06 / $113.52 / $285.47	Professional	TC	$76.06	$113.52	$285.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $74.22	Professional		$32.34	$32.34	$74.22
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $137.08 / $214.22	Professional		$109.71	$137.08	$214.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.76 / $36.67 / $49.61	Professional	26	$29.76	$36.67	$49.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.15 / $100.21 / $164.61	Professional	TC	$73.15	$100.21	$164.61