Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.99 / $15.99 / $20.42	Facility	26	$15.99	$15.99	$20.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.88 / $70.97 / $124.19	Professional		$59.88	$70.97	$124.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $16.30 / $26.97	Professional	26	$14.93	$16.30	$26.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.97 / $54.98 / $68.97	Professional	TC	$45.97	$54.98	$68.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $59.33 / $59.33	Professional		$59.33	$59.33	$59.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $22.51 / $23.93	Professional	26	$12.86	$22.51	$23.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $84.12 / $84.12 / $84.12	Professional	TC	$84.12	$84.12	$84.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.88 / $83.09 / $114.66	Professional		$60.88	$83.09	$114.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $22.65 / $31.25	Professional	26	$17.17	$22.65	$31.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $60.44 / $83.40	Professional	TC	$43.71	$60.44	$83.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.95 / $67.30 / $97.25	Professional		$16.95	$67.30	$97.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.51 / $83.39 / $139.46	Professional		$67.51	$83.39	$139.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $20.77 / $33.08	Professional	26	$16.07	$20.77	$33.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.72 / $62.22 / $101.79	Professional	TC	$49.72	$62.22	$101.79
United Facility/Professional Professional Modifier Low / Median / High Price $63.40 / $79.51 / $132.82	Professional		$63.40	$79.51	$132.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $19.63 / $32.20	Professional	26	$16.41	$19.63	$32.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.24 / $58.00 / $97.58	Professional	TC	$46.24	$58.00	$97.58