Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $20.42 / $30.90	Facility	26	$19.05	$20.42	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $223.87	Professional		$74.13	$97.72	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $46.77	Professional	26	$16.98	$23.44	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $70.79 / $141.25	Professional	TC	$54.95	$70.79	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $91.20	Professional		$57.54	$74.13	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $31.62	Professional	26	$15.14	$20.42	$31.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	TC	$77.62	$77.62	$77.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $74.13 / $107.15	Professional		$72.44	$74.13	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $20.42 / $26.30	Professional	26	$19.95	$20.42	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $53.70 / $77.62	Professional	TC	$52.48	$53.70	$77.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.12 / $30.20	Professional		$18.62	$25.12	$30.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $32.36	Facility	26	$4.90	$22.91	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $457.09	Professional		$79.43	$114.82	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $32.36 / $93.33	Professional	26	$19.50	$32.36	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $102.33 / $363.08	Professional	TC	$60.26	$102.33	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $60.26	Professional		$32.36	$33.11	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $134.90	Professional		$72.44	$85.11	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.39 / $33.88	Professional	26	$18.62	$22.39	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $64.57 / $102.33	Professional	TC	$53.70	$64.57	$102.33