Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $104.71	Facility	26	$75.86	$75.86	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $245.47	Professional		$67.61	$87.10	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $257.04	Professional	26	$44.67	$61.66	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $64.57	Professional	TC	$19.05	$28.84	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $69.18 / $77.62	Professional	26	$27.54	$69.18	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $125.89	Professional		$41.69	$41.69	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $91.20	Professional	26	$26.92	$26.92	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $28.84	Professional	TC	$14.79	$14.79	$28.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $61.66 / $112.20	Professional		$31.62	$61.66	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $95.50 / $426.58	Professional		$43.65	$95.50	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $72.44 / $281.84	Professional	26	$28.18	$72.44	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $27.54 / $147.91	Professional	TC	$13.80	$27.54	$147.91
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 $67.61 / $87.10 / $169.82	Professional		$67.61	$87.10	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $64.57 / $123.03	Professional	26	$45.71	$64.57	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $45.71	Professional	TC	$19.05	$25.70	$45.71