Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.12 / $21.42 / $43.58	Facility	26	$18.12	$21.42	$43.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.07 / $62.43 / $153.62	Professional		$32.07	$62.43	$153.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.89 / $23.00 / $43.58	Professional	26	$17.89	$23.00	$43.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.95 / $17.72 / $110.04	Professional	TC	$13.95	$17.72	$110.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.15 / $43.15 / $43.15	Professional		$43.15	$43.15	$43.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $43.68 / $123.99	Professional		$33.90	$43.68	$123.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $23.35 / $44.54	Professional	26	$14.92	$23.35	$44.54
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.87 / $65.52 / $185.98	Professional	50	$50.87	$65.52	$185.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $22.34 / $86.99	Professional	TC	$16.75	$22.34	$86.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $22.61 / $43.81	Professional		$17.27	$22.61	$43.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $125.72 / $220.19	Professional		$39.04	$125.72	$220.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.58 / $39.60 / $69.65	Professional	26	$21.58	$39.60	$69.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $85.44 / $154.19	Professional	TC	$15.65	$85.44	$154.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.38 / $32.34 / $44.88	Professional		$11.38	$32.34	$44.88
United Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $51.02 / $156.21	Professional		$33.65	$51.02	$156.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $27.78 / $43.83	Professional	26	$19.50	$27.78	$43.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $29.92 / $120.75	Professional	TC	$14.08	$29.92	$120.75