Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $12.72 / $23.19	Facility	26	$11.16	$12.72	$23.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.98 / $86.01 / $138.87	Professional		$72.98	$86.01	$138.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $12.65 / $21.06	Professional	26	$10.95	$12.65	$21.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.09 / $38.03 / $46.22	Professional	52	$37.09	$38.03	$46.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.89 / $73.44 / $114.47	Professional	TC	$63.89	$73.44	$114.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.39 / $94.89 / $116.78	Professional		$58.39	$94.89	$116.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.24 / $17.02	Professional	26	$8.51	$10.24	$17.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.53 / $112.05 / $150.94	Professional		$83.53	$112.05	$150.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $11.55 / $16.39	Professional	26	$9.71	$11.55	$16.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.31 / $100.50 / $135.66	Professional	TC	$73.31	$100.50	$135.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.17 / $70.55 / $94.89	Professional		$11.17	$70.55	$94.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.58 / $108.76 / $178.13	Professional		$73.58	$108.76	$178.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $15.49 / $25.38	Professional	26	$11.69	$15.49	$25.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.35 / $94.68 / $156.88	Professional	TC	$63.35	$94.68	$156.88
United Facility/Professional Professional Modifier Low / Median / High Price $74.19 / $103.34 / $166.90	Professional		$74.19	$103.34	$166.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $13.81 / $20.86	Professional	26	$10.85	$13.81	$20.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.06 / $92.09 / $151.93	Professional	TC	$64.06	$92.09	$151.93