Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.33 / $31.59 / $33.79	Facility	26	$26.33	$31.59	$33.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.75 / $106.50 / $194.00	Professional		$91.75	$106.50	$194.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.44 / $27.46 / $49.65	Professional	26	$25.44	$27.46	$49.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.82 / $71.95 / $101.40	Professional	TC	$62.82	$71.95	$101.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.26 / $90.75 / $142.97	Professional		$76.26	$90.75	$142.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $21.20 / $39.61	Professional	26	$21.13	$21.20	$39.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.08 / $101.43 / $148.33	Professional		$79.08	$101.43	$148.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $29.10 / $41.32	Professional	26	$23.54	$29.10	$41.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.54 / $72.34 / $108.51	Professional	TC	$55.54	$72.34	$108.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.06 / $81.02 / $120.03	Professional		$28.06	$81.02	$120.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.31 / $127.58 / $208.11	Professional		$95.31	$127.58	$208.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.97 / $35.47 / $54.21	Professional	26	$26.97	$35.47	$54.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.06 / $91.33 / $143.72	Professional	TC	$69.06	$91.33	$143.72
United Facility/Professional Professional Modifier Low / Median / High Price $91.68 / $110.87 / $190.68	Professional		$91.68	$110.87	$190.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.17 / $31.01 / $54.21	Professional	26	$25.17	$31.01	$54.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $79.39 / $136.94	Professional	TC	$67.48	$79.39	$136.94