Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.57 / $31.36 / $42.62	Facility	26	$20.57	$31.36	$42.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $52.79 / $262.70	Professional		$39.72	$52.79	$262.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $24.87 / $126.00	Professional	26	$21.37	$24.87	$126.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.18 / $21.75 / $38.65	Professional	TC	$17.18	$21.75	$38.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.22 / $46.28 / $55.24	Professional		$41.22	$46.28	$55.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.55 / $27.33 / $30.60	Professional	26	$22.55	$27.33	$30.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.11 / $24.11 / $24.11	Professional	TC	$24.11	$24.11	$24.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.61 / $50.02 / $121.25	Professional		$42.61	$50.02	$121.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $27.23 / $40.52	Professional	26	$23.15	$27.23	$40.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $22.84 / $80.06	Professional	TC	$16.30	$22.84	$80.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $27.33 / $52.46	Professional		$19.36	$27.33	$52.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $74.75 / $138.10	Professional		$40.49	$74.75	$138.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.49 / $32.93 / $57.11	Professional	26	$22.49	$32.93	$57.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.96 / $34.53 / $80.84	Professional	TC	$18.96	$34.53	$80.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $51.30	Professional		$32.34	$32.34	$51.30
United Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $53.67 / $87.10	Professional		$39.54	$53.67	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $26.56 / $38.43	Professional	26	$22.17	$26.56	$38.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $24.70 / $58.29	Professional	TC	$17.82	$24.70	$58.29