Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.20 / $52.65 / $99.49	Facility	26	$32.20	$52.65	$99.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $145.34 / $210.43	Professional		$128.72	$145.34	$210.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $38.97 / $63.04	Professional	26	$31.82	$38.97	$63.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.52 / $100.19 / $157.79	Professional	TC	$96.52	$100.19	$157.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $104.62 / $104.62	Professional		$104.62	$104.62	$104.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $29.33 / $69.44	Professional	26	$26.70	$29.33	$69.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $39.47 / $174.12	Professional		$39.47	$39.47	$174.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $22.60 / $71.90	Professional	26	$22.60	$22.60	$71.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.31 / $16.88 / $54.86	Professional	TC	$13.31	$16.88	$54.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.49 / $129.87 / $212.27	Professional		$44.49	$129.87	$212.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.24 / $30.47 / $101.53	Facility	26	$29.24	$30.47	$101.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $142.31 / $304.79	Professional		$78.48	$142.31	$304.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.62 / $61.32 / $124.69	Professional	26	$19.62	$61.32	$124.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.38 / $78.26 / $220.87	Professional	TC	$54.38	$78.26	$220.87
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 $102.17 / $161.63 / $220.87	Professional		$102.17	$161.63	$220.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.29 / $55.00 / $70.11	Professional	26	$27.29	$55.00	$70.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.57 / $100.93 / $193.47	Professional	TC	$61.57	$100.93	$193.47