Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $19.95 / $25.12	Facility	26	$13.80	$19.95	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $199.53	Professional		$57.54	$83.18	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $22.91 / $67.61	Professional	26	$12.88	$22.91	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $102.33	Professional	TC	$42.66	$52.48	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $53.70 / $107.15	Professional		$47.86	$53.70	$107.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.45 / $28.18	Professional	26	$11.48	$14.45	$28.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $54.95 / $74.13	Professional	TC	$52.48	$54.95	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $123.03	Professional		$56.23	$75.86	$123.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $32.36	Professional	26	$15.85	$20.89	$32.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $56.23 / $89.13	Professional	TC	$39.81	$56.23	$89.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $61.66 / $87.10	Professional		$15.85	$61.66	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $138.04	Professional		$60.26	$70.79	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.95 / $32.36	Professional	26	$12.88	$19.95	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $60.26 / $117.49	Professional	TC	$43.65	$60.26	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $109.65	Professional		$56.23	$67.61	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $17.38 / $28.18	Professional	26	$14.13	$17.38	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $50.12 / $83.18	Professional	TC	$42.66	$50.12	$83.18