Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $11.22 / $16.98	Facility	26	$10.00	$11.22	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $31.62 / $138.04	Facility	TC	$22.39	$31.62	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $40.74 / $144.54	Professional		$25.70	$40.74	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $52.48	Professional	26	$10.00	$16.60	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.92 / $52.48	Professional	TC	$19.95	$26.92	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $67.61	Professional		$23.44	$32.36	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $20.42	Professional	26	$8.32	$11.48	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $24.55 / $40.74	Professional	TC	$19.95	$24.55	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $42.66	Professional		$30.20	$30.20	$42.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.22 / $14.13	Professional	26	$11.22	$11.22	$14.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $19.50 / $26.30	Professional	TC	$19.50	$19.50	$26.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $25.12 / $43.65	Professional		$11.22	$25.12	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $18.20	Facility	26	$2.69	$12.59	$18.20
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	TC	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $173.78	Professional		$32.36	$45.71	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.95 / $51.29	Professional	26	$10.96	$19.95	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $120.23	Professional	TC	$20.89	$36.31	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $32.36 / $33.11	Professional		$15.85	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $35.48 / $52.48	Professional		$29.51	$35.48	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.59 / $19.05	Professional	26	$10.47	$12.59	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.91 / $35.48	Professional	TC	$19.05	$22.91	$35.48