Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.69 / $14.69 / $14.69	Facility	26	$14.69	$14.69	$14.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.04 / $117.01 / $147.04	Professional		$98.04	$117.01	$147.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.81 / $14.69 / $19.66	Professional	26	$13.81	$14.69	$19.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.23 / $102.09 / $127.83	Professional	TC	$84.23	$102.09	$127.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.86 / $110.86 / $110.86	Professional		$110.86	$110.86	$110.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.37 / $83.70 / $140.76	Professional		$53.37	$83.70	$140.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.04 / $15.47 / $21.60	Professional	26	$13.04	$15.47	$21.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.59 / $67.62 / $120.66	Professional	TC	$40.59	$67.62	$120.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.70 / $30.71 / $224.73	Professional		$15.70	$30.71	$224.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	26	$16.85	$16.85	$16.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $108.26 / $176.69	Professional		$81.06	$108.26	$176.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.76 / $17.60 / $26.52	Professional	26	$11.76	$17.60	$26.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.58 / $88.39 / $151.87	Professional	TC	$65.58	$88.39	$151.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.65 / $32.34 / $32.34	Professional		$6.65	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $67.67 / $96.63 / $170.55	Professional		$67.67	$96.63	$170.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $15.48 / $27.23	Professional	26	$11.95	$15.48	$27.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.36 / $83.34 / $145.36	Professional	TC	$56.36	$83.34	$145.36