Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $13.49 / $24.55	Facility	26	$12.88	$13.49	$24.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $102.33	Professional		$36.31	$45.71	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.85 / $34.67	Professional	26	$10.96	$15.85	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $57.54	Professional	TC	$22.91	$30.20	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $38.90 / $42.66	Professional		$20.42	$38.90	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.45 / $25.70	Professional	26	$12.88	$14.45	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $28.18	Professional	TC	$19.95	$19.95	$28.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $40.74 / $75.86	Professional		$39.81	$40.74	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $14.79 / $25.70	Professional	26	$14.13	$14.79	$25.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $26.30 / $50.12	Professional	TC	$25.12	$26.30	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $17.38 / $20.42	Professional		$10.96	$17.38	$20.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $204.17	Professional		$38.02	$67.61	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $22.91 / $64.57	Professional	26	$12.88	$22.91	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $46.77 / $141.25	Professional	TC	$25.70	$46.77	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $33.11	Professional		$21.38	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $64.57	Professional		$35.48	$42.66	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.79 / $22.91	Professional	26	$12.30	$14.79	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.18 / $41.69	Professional	TC	$22.91	$28.18	$41.69