Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $13.80 / $23.99	Facility	26	$12.88	$13.80	$23.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $38.90 / $165.96	Facility	TC	$27.54	$38.90	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.86 / $91.20	Professional		$36.31	$47.86	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $60.26	Professional	26	$10.96	$15.49	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.62 / $56.23	Professional	TC	$25.12	$31.62	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $35.48 / $41.69	Professional		$27.54	$35.48	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $13.80 / $25.12	Professional	26	$12.59	$13.80	$25.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.84 / $54.95	Professional	TC	$24.55	$28.84	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $47.86 / $89.13	Professional		$45.71	$47.86	$89.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $18.62 / $33.11	Professional	26	$17.38	$18.62	$33.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.84 / $57.54	Professional	TC	$28.18	$28.84	$57.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $16.22 / $20.42	Professional		$11.22	$16.22	$20.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.24 / $15.14 / $21.88	Facility	26	$3.24	$15.14	$21.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.24 / $33.88 / $48.98	Facility	TC	$7.24	$33.88	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $79.43 / $229.09	Professional		$39.81	$79.43	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $26.92 / $81.28	Professional	26	$13.80	$26.92	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $51.29 / $147.91	Professional	TC	$27.54	$51.29	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.36 / $33.11	Professional		$23.99	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $72.44	Professional		$38.90	$48.98	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.38 / $25.70	Professional	26	$13.49	$17.38	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.62 / $46.77	Professional	TC	$25.12	$31.62	$46.77