Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $30.20 / $41.69	Facility	26	$21.88	$30.20	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $549.54	Professional		$177.83	$229.09	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $22.91 / $57.54	Professional	26	$19.95	$22.91	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $194.98 / $309.03	Professional	TC	$158.49	$194.98	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $43.65	Professional	26	$17.38	$23.99	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $309.03	Professional	TC	$169.82	$169.82	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $295.12	Professional		$213.80	$213.80	$295.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $22.91 / $32.36	Professional	26	$22.91	$22.91	$32.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $263.03	Professional	TC	$190.55	$190.55	$263.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.84 / $35.48	Professional		$21.38	$28.84	$35.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $457.09 / $1,000.00	Professional		$281.84	$457.09	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $47.86 / $107.15	Professional	26	$28.84	$47.86	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $891.25	Professional	TC	$257.04	$407.38	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $208.93	Professional		$32.36	$33.11	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $354.81	Professional		$223.87	$275.42	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $38.02	Professional	26	$23.99	$28.84	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $251.19 / $316.23	Professional	TC	$199.53	$251.19	$316.23