Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.78 / $33.97 / $47.89	Facility	26	$25.78	$33.97	$47.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.68 / $119.30 / $516.00	Professional		$97.68	$119.30	$516.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $31.53 / $118.82	Professional	26	$24.76	$31.53	$118.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.61 / $82.79 / $137.19	Professional	TC	$70.61	$82.79	$137.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.36 / $108.36 / $110.49	Professional		$108.36	$108.36	$110.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.27 / $26.79 / $31.98	Professional	26	$24.27	$26.79	$31.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $104.65 / $157.88	Professional		$86.70	$104.65	$157.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $27.92 / $43.22	Professional	26	$23.38	$27.92	$43.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.32 / $74.50 / $121.66	Professional	TC	$63.32	$74.50	$121.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $71.47 / $118.99	Professional		$25.12	$71.47	$118.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $141.80 / $216.15	Professional		$92.75	$141.80	$216.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $38.53 / $56.34	Professional	26	$25.05	$38.53	$56.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.34 / $105.91 / $171.28	Professional	TC	$68.34	$105.91	$171.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $91.55	Professional		$32.34	$32.34	$91.55
United Facility/Professional Professional Modifier Low / Median / High Price $93.07 / $130.12 / $203.31	Professional		$93.07	$130.12	$203.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.37 / $35.07 / $48.08	Professional	26	$25.37	$35.07	$48.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.91 / $93.54 / $126.02	Professional	TC	$66.91	$93.54	$126.02