Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.27 / $66.12 / $112.36	Facility	26	$56.27	$66.12	$112.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $101.04 / $163.13	Professional		$83.62	$101.04	$163.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.90 / $60.81 / $112.05	Professional	26	$54.90	$60.81	$112.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $42.67 / $64.31	Professional	TC	$26.89	$42.67	$64.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.61 / $119.53 / $119.53	Professional		$112.61	$119.53	$119.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $56.52 / $63.93	Professional	26	$56.52	$56.52	$63.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.52 / $85.32 / $121.86	Professional		$72.52	$85.32	$121.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.72 / $61.17 / $85.35	Professional	26	$51.72	$61.17	$85.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.52 / $24.15 / $37.97	Professional	TC	$20.52	$24.15	$37.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.02 / $60.47 / $116.94	Professional		$39.02	$60.47	$116.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.81 / $62.81 / $62.81	Facility	26	$62.81	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.89 / $113.61 / $171.85	Professional		$85.89	$113.61	$171.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.34 / $78.45 / $116.04	Professional	26	$52.34	$78.45	$116.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $35.24 / $65.72	Professional	TC	$26.35	$35.24	$65.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $112.61	Professional		$32.34	$32.34	$112.61
United Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $98.89 / $170.52	Professional		$75.48	$98.89	$170.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.81 / $66.00 / $111.51	Professional	26	$52.81	$66.00	$111.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.42 / $32.58 / $56.89	Professional	TC	$23.42	$32.58	$56.89