Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $15.90 / $19.77	Facility	26	$13.95	$15.90	$19.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $65.03 / $127.00	Professional		$56.75	$65.03	$127.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.65 / $29.00	Professional	26	$13.18	$14.65	$29.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $49.05 / $80.73	Professional	TC	$42.39	$49.05	$80.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.85 / $68.18 / $94.94	Professional		$50.85	$68.18	$94.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $16.70 / $20.88	Professional	26	$11.14	$16.70	$20.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.06 / $74.06 / $74.06	Professional	TC	$74.06	$74.06	$74.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.01 / $76.45 / $114.67	Professional		$56.01	$76.45	$114.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $20.77 / $28.66	Professional	26	$15.74	$20.77	$28.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.27 / $55.68 / $83.52	Professional	TC	$40.27	$55.68	$83.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.62 / $56.78 / $82.28	Professional		$14.62	$56.78	$82.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.29 / $74.90 / $136.80	Professional		$57.29	$74.90	$136.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $19.18 / $29.90	Professional	26	$14.32	$19.18	$29.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.45 / $56.21 / $108.20	Professional	TC	$44.45	$56.21	$108.20
United Facility/Professional Professional Modifier Low / Median / High Price $58.25 / $68.56 / $116.57	Professional		$58.25	$68.56	$116.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.11 / $17.43 / $28.34	Professional	26	$14.11	$17.43	$28.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.45 / $51.83 / $99.76	Professional	TC	$42.45	$51.83	$99.76