Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.70 / $25.70	Facility	26	$25.12	$25.70	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $288.40	Professional		$87.10	$112.20	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.20 / $141.25	Professional	26	$20.89	$30.20	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $79.43 / $125.89	Professional	TC	$63.10	$79.43	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $117.49	Professional		$54.95	$54.95	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $23.44 / $35.48	Professional	26	$14.13	$23.44	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $91.20	Professional		$53.70	$53.70	$91.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $27.54	Professional	26	$14.79	$14.79	$27.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $38.90 / $64.57	Professional	TC	$38.90	$38.90	$64.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $69.18	Professional		$30.90	$42.66	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $70.79 / $102.33	Facility	26	$15.14	$70.79	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $173.78 / $602.56	Professional		$58.88	$173.78	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $42.66 / $151.36	Professional	26	$15.49	$42.66	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $125.89 / $446.68	Professional	TC	$42.66	$125.89	$446.68
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 $77.62 / $107.15 / $199.53	Professional		$77.62	$107.15	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $30.20 / $53.70	Professional	26	$21.38	$30.20	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $77.62 / $144.54	Professional	TC	$56.23	$77.62	$144.54