Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $30.20 / $43.65	Facility	26	$22.39	$30.20	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $83.18 / $331.13	Professional		$41.69	$83.18	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $33.88 / $85.11	Professional	26	$19.05	$33.88	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $74.13	Professional	TC	$19.05	$30.20	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $42.66 / $64.57	Professional		$34.67	$42.66	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $24.55 / $45.71	Professional	26	$17.78	$24.55	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $24.55 / $48.98	Professional	TC	$12.88	$24.55	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $58.88 / $93.33	Professional		$48.98	$58.88	$93.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $18.20 / $31.62	Professional	26	$17.78	$18.20	$31.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $32.36 / $64.57	Professional	TC	$30.90	$32.36	$64.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $57.54	Professional		$22.91	$29.51	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $26.92 / $38.02	Facility	26	$5.75	$26.92	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $100.00 / $323.59	Professional		$40.74	$100.00	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $32.36 / $109.65	Professional	26	$19.95	$32.36	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $67.61 / $263.03	Professional	TC	$22.91	$67.61	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $46.77	Professional		$28.84	$32.36	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $102.33	Professional		$40.74	$77.62	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $22.91 / $38.02	Professional	26	$17.78	$22.91	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $39.81 / $81.28	Professional	TC	$19.50	$39.81	$81.28