Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.16 / $36.63 / $46.46	Facility	26	$23.16	$36.63	$46.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.02 / $92.50 / $172.37	Professional		$84.02	$92.50	$172.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $25.71 / $47.60	Professional	26	$23.17	$25.71	$47.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.00 / $69.26 / $120.95	Professional	TC	$60.00	$69.26	$120.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.55 / $64.55 / $64.55	Professional		$64.55	$64.55	$64.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $19.38 / $25.67	Professional	26	$19.38	$19.38	$25.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $81.05 / $127.61	Professional		$67.00	$81.05	$127.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $24.37 / $41.66	Professional	26	$21.46	$24.37	$41.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.84 / $53.93 / $88.01	Professional	TC	$45.84	$53.93	$88.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $38.96 / $124.30	Professional		$28.00	$38.96	$124.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.86 / $120.26 / $201.71	Professional		$85.86	$120.26	$201.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $36.86 / $54.43	Professional	26	$25.11	$36.86	$54.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $84.96 / $156.38	Professional	TC	$61.88	$84.96	$156.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $65.24	Professional		$32.34	$32.34	$65.24
United Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $98.17 / $135.41	Professional		$78.84	$98.17	$135.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $28.51 / $42.77	Professional	26	$23.81	$28.51	$42.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.34 / $71.52 / $101.64	Professional	TC	$54.34	$71.52	$101.64