Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $13.80 / $23.25	Facility	26	$13.80	$13.80	$23.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.01 / $37.14 / $95.74	Facility	TC	$28.01	$37.14	$95.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $41.81 / $52.75	Professional		$36.88	$41.81	$52.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $14.04 / $17.48	Professional	26	$12.91	$14.04	$17.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $28.01 / $35.26	Professional	TC	$23.47	$28.01	$35.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $35.79 / $35.79	Professional		$35.79	$35.79	$35.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $11.12 / $24.33	Professional	26	$11.01	$11.12	$24.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.39 / $39.21 / $60.77	Professional		$38.39	$39.21	$60.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $15.58 / $23.51	Professional	26	$15.58	$15.58	$23.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.79 / $23.63 / $36.61	Professional	TC	$22.79	$23.63	$36.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.62 / $34.49 / $55.84	Professional		$14.62	$34.49	$55.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.07 / $91.48	Professional		$38.90	$51.07	$91.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $18.91 / $29.49	Professional	26	$13.86	$18.91	$29.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.13 / $32.10 / $60.00	Professional	TC	$25.13	$32.10	$60.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $45.47 / $79.88	Professional		$39.54	$45.47	$79.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $17.55 / $28.22	Professional	26	$14.44	$17.55	$28.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $28.72 / $49.08	Professional	TC	$23.63	$28.72	$49.08