Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.58 / $17.30 / $33.36	Facility	26	$15.58	$17.30	$33.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.88 / $103.93 / $192.06	Professional		$81.88	$103.93	$192.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $17.67 / $71.00	Professional	26	$16.23	$17.67	$71.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.30 / $87.32 / $143.35	Professional	TC	$66.30	$87.32	$143.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $72.20 / $72.20	Professional		$72.20	$72.20	$72.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $16.88 / $23.63	Professional	26	$13.50	$16.88	$23.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $79.63 / $118.05	Professional		$67.34	$79.63	$118.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $17.73 / $30.11	Professional	26	$15.39	$17.73	$30.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.65 / $63.78 / $95.14	Professional	TC	$53.65	$63.78	$95.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $77.33 / $118.61	Professional		$18.98	$77.33	$118.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $117.60 / $195.30	Professional		$80.20	$117.60	$195.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.42 / $25.41 / $38.14	Professional	26	$17.42	$25.41	$38.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.64 / $95.85 / $181.38	Professional	TC	$61.64	$95.85	$181.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $59.93	Professional		$32.34	$32.34	$59.93
United Facility/Professional Professional Modifier Low / Median / High Price $73.31 / $104.48 / $138.80	Professional		$73.31	$104.48	$138.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $19.19 / $28.70	Professional	26	$15.88	$19.19	$28.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.39 / $81.80 / $110.14	Professional	TC	$58.39	$81.80	$110.14