Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $38.02 / $38.02	Facility	26	$36.31	$38.02	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $131.83 / $173.78	Professional		$63.10	$131.83	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $40.74 / $63.10	Professional	26	$34.67	$40.74	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $95.50 / $123.03	Professional	TC	$18.20	$95.50	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Professional	26	$51.29	$51.29	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $229.09	Professional		$54.95	$66.07	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $46.77 / $87.10	Professional	26	$43.65	$46.77	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $11.22 / $141.25	Professional	TC	$9.55	$11.22	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $61.66	Professional		$36.31	$51.29	$61.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $64.57	Facility	26	$9.77	$45.71	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $186.21 / $645.65	Professional		$81.28	$186.21	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $74.13 / $199.53	Professional	26	$40.74	$74.13	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $123.03 / $457.09	Professional	TC	$25.70	$123.03	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $112.20 / $165.96	Professional		$63.10	$112.20	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.67 / $64.57	Professional	26	$37.15	$44.67	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $67.61 / $114.82	Professional	TC	$18.20	$67.61	$114.82