Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.15 / $75.44 / $104.44	Facility	26	$46.15	$75.44	$104.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.58 / $71.19 / $112.12	Professional		$68.58	$71.19	$112.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.47 / $47.90 / $75.44	Professional	26	$45.47	$47.90	$75.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $24.77 / $39.76	Professional	TC	$22.44	$24.77	$39.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.06 / $41.68 / $72.25	Professional	26	$28.06	$41.68	$72.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $41.48 / $121.64	Professional		$41.48	$41.48	$121.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $26.64 / $86.42	Professional	26	$26.64	$26.64	$86.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $14.84 / $33.74	Professional	TC	$14.84	$14.84	$33.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.68 / $67.25 / $115.15	Professional		$30.68	$67.25	$115.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.53 / $91.53 / $91.53	Facility	26	$91.53	$91.53	$91.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $93.30 / $155.83	Professional		$42.20	$93.30	$155.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.26 / $72.73 / $127.91	Professional	26	$28.26	$72.73	$127.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.94 / $22.14 / $56.16	Professional	TC	$13.94	$22.14	$56.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $88.03 / $138.05	Professional		$53.04	$88.03	$138.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.76 / $63.96 / $100.14	Professional	26	$38.76	$63.96	$100.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $25.63 / $44.24	Professional	TC	$19.12	$25.63	$44.24