Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $19.95 / $26.92	Facility	26	$14.79	$19.95	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $112.20	Professional		$33.11	$47.86	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.98 / $38.02	Professional	26	$12.02	$16.98	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $52.48	Professional	TC	$19.95	$28.84	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $75.86	Professional		$30.90	$30.90	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.88 / $14.45 / $33.88	Professional	26	$2.88	$14.45	$33.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $46.77 / $104.71	Professional		$42.66	$46.77	$104.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.98 / $29.51	Professional	26	$16.60	$16.98	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $27.54 / $67.61	Professional	TC	$26.30	$27.54	$67.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $19.05 / $22.39	Professional		$14.13	$19.05	$22.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $77.62 / $251.19	Professional		$37.15	$77.62	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $26.92 / $77.62	Professional	26	$14.79	$26.92	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $57.54 / $199.53	Professional	TC	$22.91	$57.54	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $41.69	Professional		$28.84	$32.36	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $77.62	Professional		$35.48	$54.95	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $16.98 / $25.70	Professional	26	$14.13	$16.98	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $36.31 / $58.88	Professional	TC	$20.42	$36.31	$58.88