Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.14 / $46.42 / $83.48	Facility	26	$41.14	$46.42	$83.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.66 / $165.59 / $701.00	Professional		$142.66	$165.59	$701.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $46.42 / $94.19	Professional	26	$42.89	$46.42	$94.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.29 / $111.43 / $193.59	Professional	TC	$97.29	$111.43	$193.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.42 / $154.38 / $208.20	Professional		$108.42	$154.38	$208.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $47.06 / $56.86	Professional	26	$34.99	$47.06	$56.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.06 / $95.06 / $106.00	Professional	TC	$95.06	$95.06	$106.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $128.22 / $181.00	Professional		$128.22	$128.22	$181.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.60 / $38.60 / $54.48	Professional	26	$38.60	$38.60	$54.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.63 / $89.63 / $126.52	Professional	TC	$89.63	$89.63	$126.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.19 / $109.32 / $194.32	Professional		$50.19	$109.32	$194.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.13 / $211.94 / $353.62	Professional		$143.13	$211.94	$353.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.08 / $65.89 / $109.50	Professional	26	$47.08	$65.89	$109.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.87 / $148.69 / $244.12	Professional	TC	$108.87	$148.69	$244.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $133.10	Professional		$32.34	$32.34	$133.10
United Facility/Professional Professional Modifier Low / Median / High Price $155.44 / $189.21 / $233.50	Professional		$155.44	$189.21	$233.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.65 / $56.88 / $75.39	Professional	26	$45.65	$56.88	$75.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.87 / $128.91 / $167.47	Professional	TC	$104.87	$128.91	$167.47