Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $20.42 / $26.30	Facility	26	$13.18	$20.42	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $151.36	Professional		$51.29	$77.62	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $21.38 / $57.54	Professional	26	$12.02	$21.38	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $47.86 / $95.50	Professional	TC	$36.31	$47.86	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $81.28	Professional		$41.69	$48.98	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $12.88 / $26.92	Professional	26	$10.72	$12.88	$26.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $44.67 / $53.70	Professional	TC	$35.48	$44.67	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $104.71	Professional		$57.54	$64.57	$104.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $36.31	Professional	26	$16.98	$23.44	$36.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $40.74 / $72.44	Professional	TC	$38.90	$40.74	$72.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $52.48 / $75.86	Professional		$15.14	$52.48	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $144.54	Professional		$50.12	$77.62	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $20.89 / $38.02	Professional	26	$12.59	$20.89	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $57.54 / $104.71	Professional	TC	$38.90	$57.54	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $104.71	Professional		$52.48	$66.07	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $28.18	Professional	26	$14.13	$18.62	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $47.86 / $75.86	Professional	TC	$38.02	$47.86	$75.86