Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $51.12 / $108.65	Facility	26	$31.27	$51.12	$108.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $109.90 / $166.88	Professional		$93.33	$109.90	$166.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.19 / $31.72 / $51.12	Professional	26	$30.19	$31.72	$51.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.15 / $78.18 / $115.76	Professional	TC	$63.15	$78.18	$115.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.01 / $48.01 / $48.01	Professional	26	$48.01	$48.01	$48.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.14 / $88.50 / $265.56	Professional		$84.14	$88.50	$265.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $24.51 / $98.01	Professional	26	$24.51	$24.51	$98.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.63 / $76.95 / $121.44	Professional	TC	$56.63	$76.95	$121.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $86.42 / $183.88	Professional		$45.71	$86.42	$183.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.89 / $84.89 / $84.89	Facility	26	$84.89	$84.89	$84.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.19 / $163.01 / $345.65	Professional		$67.19	$163.01	$345.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $59.50 / $117.60	Professional	26	$19.47	$59.50	$117.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.61 / $98.85 / $242.38	Professional	TC	$44.61	$98.85	$242.38
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 $118.82 / $134.91 / $247.90	Professional		$118.82	$134.91	$247.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $60.64 / $82.82	Professional	26	$39.64	$60.64	$82.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.24 / $90.58 / $156.69	Professional	TC	$60.24	$90.58	$156.69