Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $73.65 / $206.80	Professional		$61.97	$73.65	$206.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.55 / $64.34 / $231.66	Professional	26	$21.55	$64.34	$231.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $51.32 / $215.97	Professional	TC	$29.46	$51.32	$215.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.45 / $51.77 / $87.46	Professional		$41.45	$51.77	$87.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $16.30 / $38.60	Professional	26	$12.86	$16.30	$38.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $31.60 / $57.42	Professional		$31.60	$31.60	$57.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $10.58 / $13.96	Professional	26	$10.58	$10.58	$13.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $21.02 / $46.25	Professional	TC	$21.02	$21.02	$46.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.24 / $74.08 / $113.70	Facility		$26.24	$74.08	$113.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $67.90 / $109.49	Professional		$25.73	$67.90	$109.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.36 / $87.36 / $87.36	Facility		$87.36	$87.36	$87.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.39 / $69.02 / $129.41	Professional		$30.39	$69.02	$129.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $22.04 / $44.67	Professional	26	$10.48	$22.04	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.29 / $46.82 / $92.47	Professional	TC	$20.29	$46.82	$92.47
United Facility/Professional Professional Modifier Low / Median / High Price $52.42 / $88.45 / $159.87	Professional		$52.42	$88.45	$159.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.75 / $28.90 / $50.30	Professional	26	$17.75	$28.90	$50.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.57 / $58.79 / $107.59	Professional	TC	$35.57	$58.79	$107.59