Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.46 / $23.82 / $41.37	Facility	26	$19.46	$23.82	$41.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.27 / $123.07 / $220.82	Professional		$114.27	$123.07	$220.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $22.93 / $42.50	Professional	26	$15.93	$22.93	$42.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $105.01 / $172.15	Professional	TC	$91.66	$105.01	$172.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $25.17 / $39.81	Professional	26	$16.78	$25.17	$39.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.67 / $109.83 / $183.98	Professional		$83.67	$109.83	$183.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $15.89 / $32.10	Professional	26	$12.39	$15.89	$32.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.28 / $93.91 / $163.06	Professional	TC	$71.28	$93.91	$163.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $34.13 / $163.07	Professional		$24.48	$34.13	$163.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $171.69 / $290.87	Professional		$113.14	$171.69	$290.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $24.14 / $47.42	Professional	26	$17.57	$24.14	$47.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.27 / $143.94 / $261.39	Professional	TC	$94.27	$143.94	$261.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $94.83	Professional		$32.34	$32.34	$94.83
United Facility/Professional Professional Modifier Low / Median / High Price $122.07 / $167.04 / $240.98	Professional		$122.07	$167.04	$240.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.05 / $23.82 / $49.04	Professional	26	$15.05	$23.82	$49.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.72 / $140.83 / $194.11	Professional	TC	$93.72	$140.83	$194.11