Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $14.41 / $20.45	Facility	26	$13.18	$14.41	$20.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $57.44 / $219.02	Professional		$51.49	$57.44	$219.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $15.52 / $35.89	Professional	26	$13.95	$15.52	$35.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.22 / $42.80 / $81.43	Professional	TC	$37.22	$42.80	$81.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $46.35 / $50.75	Professional		$40.36	$46.35	$50.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $11.39 / $22.77	Professional	26	$11.07	$11.39	$22.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.01 / $40.01 / $40.01	Professional	TC	$40.01	$40.01	$40.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.01 / $52.54 / $75.31	Professional		$51.01	$52.54	$75.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $16.21 / $21.03	Professional	26	$14.65	$16.21	$21.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.28 / $36.34 / $52.83	Professional	TC	$35.28	$36.34	$52.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $46.01 / $75.64	Professional		$15.49	$46.01	$75.64
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 $53.07 / $72.93 / $117.56	Professional		$53.07	$72.93	$117.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.07 / $21.92 / $36.25	Professional	26	$15.07	$21.92	$36.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.51 / $53.91 / $81.31	Professional	TC	$38.51	$53.91	$81.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $32.34 / $43.94	Professional		$30.37	$32.34	$43.94
United Facility/Professional Professional Modifier Low / Median / High Price $49.73 / $59.91 / $83.87	Professional		$49.73	$59.91	$83.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $17.62 / $24.93	Professional	26	$14.43	$17.62	$24.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $43.67 / $65.06	Professional	TC	$34.97	$43.67	$65.06