Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.17 / $22.17 / $25.98	Facility	26	$22.17	$22.17	$25.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.87 / $129.94 / $198.99	Professional		$113.87	$129.94	$198.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $22.95 / $29.86	Professional	26	$18.76	$22.95	$29.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.70 / $103.86 / $172.72	Professional	TC	$91.70	$103.86	$172.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $16.91 / $35.21	Professional	26	$16.89	$16.91	$35.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.08 / $150.19 / $202.77	Professional		$123.08	$150.19	$202.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.60 / $38.61	Professional	26	$19.05	$28.60	$38.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.87 / $121.60 / $164.16	Professional	TC	$99.87	$121.60	$164.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $97.78 / $133.34	Professional		$22.45	$97.78	$133.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.67 / $161.28 / $261.30	Professional		$120.67	$161.28	$261.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.29 / $26.72 / $47.55	Professional	26	$20.29	$26.72	$47.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.02 / $132.46 / $219.15	Professional	TC	$97.02	$132.46	$219.15
United Facility/Professional Professional Modifier Low / Median / High Price $115.07 / $155.94 / $238.82	Professional		$115.07	$155.94	$238.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.58 / $25.98 / $41.41	Professional	26	$20.58	$25.98	$41.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.58 / $125.56 / $201.80	Professional	TC	$89.58	$125.56	$201.80