Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Facility	26	$42.66	$42.66	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $102.33	Professional		$57.54	$67.61	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $85.11	Professional	26	$39.81	$47.86	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $19.05 / $28.84	Professional	TC	$15.85	$19.05	$28.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	26	$47.86	$47.86	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $67.61 / $128.82	Professional		$63.10	$67.61	$128.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $48.98 / $89.13	Professional	26	$46.77	$48.98	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $18.62 / $38.02	Professional	TC	$17.38	$18.62	$38.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $22.91 / $26.92	Professional		$16.60	$22.91	$26.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $52.48 / $75.86	Facility	26	$11.22	$52.48	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $114.82 / $309.03	Professional		$61.66	$114.82	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $83.18 / $218.78	Professional	26	$44.67	$83.18	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $91.20	Professional	TC	$19.05	$32.36	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $67.61	Professional		$32.36	$33.11	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $100.00	Professional		$56.23	$66.07	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $46.77 / $72.44	Professional	26	$39.81	$46.77	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $19.50 / $27.54	Professional	TC	$16.22	$19.50	$27.54