Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.56 / $7.40 / $11.32	Facility	26	$5.56	$7.40	$11.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.37 / $24.12 / $253.57	Facility	TC	$18.37	$24.12	$253.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $31.85 / $123.00	Professional		$23.93	$31.85	$123.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.56 / $6.60 / $25.00	Professional	26	$5.56	$6.60	$25.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.37 / $23.80 / $45.51	Professional	TC	$18.37	$23.80	$45.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.94 / $31.53 / $31.53	Professional		$18.94	$31.53	$31.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $4.74 / $6.94	Professional	26	$4.68	$4.74	$6.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.21 / $26.01 / $39.83	Professional		$22.21	$26.01	$39.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $6.85 / $11.58	Professional	26	$5.82	$6.85	$11.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.31 / $19.16 / $29.46	Professional	TC	$15.31	$19.16	$29.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.73 / $22.20 / $35.31	Professional		$6.73	$22.20	$35.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.00 / $35.77 / $58.67	Professional		$23.00	$35.77	$58.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $9.30 / $14.48	Professional	26	$6.17	$9.30	$14.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $26.75 / $46.27	Professional	TC	$17.39	$26.75	$46.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $32.34 / $32.34	Professional		$11.91	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $27.97 / $39.90	Professional		$21.85	$27.97	$39.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.69 / $6.95 / $10.29	Professional	26	$5.69	$6.95	$10.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.56 / $21.66 / $32.47	Professional	TC	$15.56	$21.66	$32.47