Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.61 / $14.00 / $25.63	Facility	26	$12.61	$14.00	$25.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $67.65 / $127.62	Professional		$55.86	$67.65	$127.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.33 / $16.71 / $38.47	Professional	26	$13.33	$16.71	$38.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.63 / $45.67 / $89.71	Professional	TC	$40.63	$45.67	$89.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $59.66 / $65.45	Professional		$40.36	$59.66	$65.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $12.69 / $25.52	Professional	26	$10.64	$12.69	$25.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.13 / $60.15 / $95.66	Professional		$51.13	$60.15	$95.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $19.76 / $31.23	Professional	26	$16.30	$19.76	$31.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.34 / $40.40 / $62.64	Professional	TC	$33.34	$40.40	$62.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.83 / $46.67 / $75.59	Professional		$14.83	$46.67	$75.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.88 / $78.80 / $125.41	Professional		$55.88	$78.80	$125.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $24.31 / $36.71	Professional	26	$16.61	$24.31	$36.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.04 / $55.45 / $89.84	Professional	TC	$42.04	$55.45	$89.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $32.34 / $48.13	Professional		$31.89	$32.34	$48.13
United Facility/Professional Professional Modifier Low / Median / High Price $52.43 / $64.17 / $84.38	Professional		$52.43	$64.17	$84.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $18.25 / $23.83	Professional	26	$14.67	$18.25	$23.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.14 / $46.29 / $62.65	Professional	TC	$37.14	$46.29	$62.65