Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.49 / $37.53 / $67.94	Facility	26	$33.49	$37.53	$67.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $130.40 / $553.00	Professional		$109.50	$130.40	$553.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $37.53 / $76.47	Professional	26	$34.46	$37.53	$76.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.34 / $92.64 / $164.93	Professional	TC	$76.34	$92.64	$164.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.09 / $140.56 / $165.36	Professional		$86.09	$140.56	$165.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.49 / $38.34 / $46.29	Professional	26	$28.49	$38.34	$46.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.09 / $83.15 / $83.15	Professional	TC	$77.09	$83.15	$83.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.18 / $101.18 / $142.82	Professional		$101.18	$101.18	$142.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.84 / $32.79 / $44.80	Professional	26	$31.84	$32.79	$44.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.38 / $68.38 / $99.05	Professional	TC	$68.38	$68.38	$99.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $85.82 / $154.34	Professional		$40.79	$85.82	$154.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $43.97	Facility	26	$43.97	$43.97	$43.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $167.17 / $278.93	Professional		$113.14	$167.17	$278.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.36 / $53.34 / $88.12	Professional	26	$38.36	$53.34	$88.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.90 / $116.83 / $190.81	Professional	TC	$84.90	$116.83	$190.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $105.15	Professional		$32.34	$32.34	$105.15
United Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $150.06 / $190.35	Professional		$118.69	$150.06	$190.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $46.05 / $60.68	Professional	26	$37.22	$46.05	$60.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.09 / $101.33 / $132.38	Professional	TC	$81.09	$101.33	$132.38