Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.04 / $66.04 / $77.38	Facility	26	$66.04	$66.04	$77.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $109.04 / $165.67	Professional		$90.76	$109.04	$165.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.67 / $66.04 / $84.64	Professional	26	$59.67	$66.04	$84.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.24 / $45.56 / $58.01	Professional	TC	$27.24	$45.56	$58.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.60 / $119.38 / $143.25	Professional		$114.60	$119.38	$143.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.59 / $69.59 / $69.59	Professional	26	$69.59	$69.59	$69.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.09 / $121.76 / $192.98	Professional		$81.09	$121.76	$192.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.48 / $86.28 / $136.75	Professional	26	$56.48	$86.28	$136.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.04 / $35.47 / $56.21	Professional	TC	$24.04	$35.47	$56.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.31 / $64.02 / $121.60	Professional		$42.31	$64.02	$121.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $68.20 / $68.20	Facility	26	$68.20	$68.20	$68.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $135.47 / $214.43	Professional		$104.71	$135.47	$214.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.42 / $87.68 / $132.22	Professional	26	$63.42	$87.68	$132.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $43.70 / $74.27	Professional	TC	$32.79	$43.70	$74.27
United Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $100.95 / $159.21	Professional		$81.72	$100.95	$159.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.92 / $70.00 / $106.40	Professional	26	$53.92	$70.00	$106.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.95 / $33.00 / $54.98	Professional	TC	$24.95	$33.00	$54.98