Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.25 / $29.92 / $39.45	Facility	26	$26.25	$29.92	$39.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $60.43 / $88.23	Professional		$56.98	$60.43	$88.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $27.91 / $42.01	Professional	26	$25.30	$27.91	$42.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $33.03 / $50.31	Professional	TC	$30.06	$33.03	$50.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.53 / $52.43 / $59.13	Professional		$51.53	$52.43	$59.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $33.01 / $38.09	Professional	26	$24.42	$33.01	$38.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.02 / $88.68 / $140.85	Professional		$50.02	$88.68	$140.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $45.56 / $72.20	Professional	26	$26.12	$45.56	$72.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $43.12 / $70.02	Professional	TC	$23.89	$43.12	$70.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $38.09 / $72.01	Professional		$26.66	$38.09	$72.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.04 / $87.09 / $179.48	Professional		$62.04	$87.09	$179.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.66 / $36.40 / $60.49	Professional	26	$26.66	$36.40	$60.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.07 / $44.86 / $158.26	Professional	TC	$31.07	$44.86	$158.26
United Facility/Professional Professional Modifier Low / Median / High Price $50.02 / $60.27 / $93.98	Professional		$50.02	$60.27	$93.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.21 / $29.58 / $46.32	Professional	26	$24.21	$29.58	$46.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $31.34 / $48.80	Professional	TC	$24.83	$31.34	$48.80