Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.74 / $48.20 / $64.25	Facility	26	$31.74	$48.20	$64.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.08 / $97.64 / $446.00	Professional		$74.08	$97.64	$446.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $38.89 / $89.40	Professional	26	$33.34	$38.89	$89.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.17 / $49.35 / $85.96	Professional	TC	$39.17	$49.35	$85.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.88 / $89.17 / $106.43	Professional		$78.88	$89.17	$106.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.30 / $37.27 / $43.84	Professional	26	$27.30	$37.27	$43.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.73 / $57.09 / $58.00	Professional	TC	$46.73	$57.09	$58.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.42 / $93.80 / $146.19	Professional		$76.42	$93.80	$146.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.79 / $38.01 / $60.49	Professional	26	$31.79	$38.01	$60.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.98 / $52.25 / $88.90	Professional	TC	$43.98	$52.25	$88.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $52.86 / $101.43	Professional		$37.09	$52.86	$101.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $118.95 / $187.41	Professional		$77.62	$118.95	$187.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.71 / $50.79 / $79.64	Professional	26	$34.71	$50.79	$79.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.52 / $69.80 / $109.72	Professional	TC	$43.52	$69.80	$109.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $98.83	Professional		$32.34	$32.34	$98.83
United Facility/Professional Professional Modifier Low / Median / High Price $72.64 / $94.37 / $125.00	Professional		$72.64	$94.37	$125.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $40.32 / $59.01	Professional	26	$34.04	$40.32	$59.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.75 / $52.49 / $79.94	Professional	TC	$39.75	$52.49	$79.94