Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $41.69 / $42.66	Facility	26	$23.99	$41.69	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $295.12	Professional		$112.20	$158.49	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $75.86	Professional	26	$20.89	$25.70	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $112.20 / $208.93	Professional	TC	$91.20	$112.20	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $17.78 / $26.30	Professional	26	$17.78	$17.78	$26.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $181.97	Professional		$125.89	$151.36	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.05 / $32.36	Professional	26	$16.22	$19.05	$32.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $131.83 / $154.88	Professional	TC	$102.33	$131.83	$154.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $29.51 / $34.67	Professional		$20.89	$29.51	$34.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $575.44	Professional		$117.49	$194.98	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $107.15	Professional	26	$21.88	$33.88	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $165.96 / $478.63	Professional	TC	$97.72	$165.96	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $72.44	Professional		$32.36	$33.11	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $245.47	Professional		$114.82	$158.49	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $25.70 / $48.98	Professional	26	$19.50	$25.70	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $131.83 / $199.53	Professional	TC	$91.20	$131.83	$199.53