Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.90 / $43.90 / $58.62	Facility	26	$43.90	$43.90	$58.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.86 / $139.91 / $200.60	Professional		$113.86	$139.91	$200.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $44.16 / $67.64	Professional	26	$40.24	$44.16	$67.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.30 / $87.86 / $137.16	Professional	TC	$71.30	$87.86	$137.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.36 / $103.78 / $137.32	Professional		$99.36	$103.78	$137.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.83 / $168.21 / $219.45	Professional		$107.83	$168.21	$219.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.07 / $43.60 / $66.70	Professional	26	$32.07	$43.60	$66.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.45 / $120.12 / $160.16	Professional	TC	$63.45	$120.12	$160.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $57.79 / $135.85	Professional		$44.24	$57.79	$135.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.59 / $160.19 / $284.02	Professional		$110.59	$160.19	$284.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.98 / $62.48 / $98.78	Professional	26	$41.98	$62.48	$98.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.12 / $97.94 / $196.57	Professional	TC	$65.12	$97.94	$196.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.61 / $102.70	Professional		$32.34	$36.61	$102.70
United Facility/Professional Professional Modifier Low / Median / High Price $104.70 / $138.88 / $243.54	Professional		$104.70	$138.88	$243.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.86 / $56.20 / $92.91	Professional	26	$39.86	$56.20	$92.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $89.97 / $153.87	Professional	TC	$61.86	$89.97	$153.87