Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.71 / $124.99 / $578.65	Facility		$35.71	$124.99	$578.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.34 / $14.39 / $24.59	Facility	26	$12.34	$14.39	$24.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $36.20 / $65.73	Professional		$32.22	$36.20	$65.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.34 / $14.37 / $53.03	Professional	26	$12.34	$14.37	$53.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $22.48 / $41.58	Professional	TC	$19.80	$22.48	$41.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.08 / $33.85 / $33.85	Professional		$27.08	$33.85	$33.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $15.70 / $17.57	Professional	26	$10.18	$15.70	$17.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $33.85 / $50.01	Professional		$30.58	$33.85	$50.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $15.43 / $23.80	Professional	26	$13.94	$15.43	$23.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.34 / $19.50 / $29.46	Professional	TC	$16.34	$19.50	$29.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.82 / $28.74 / $47.73	Facility		$13.82	$28.74	$47.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.82 / $25.12 / $47.39	Professional		$13.82	$25.12	$47.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Facility		$42.87	$42.87	$42.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $43.43 / $67.93	Professional		$31.11	$43.43	$67.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $20.19 / $30.54	Professional	26	$13.23	$20.19	$30.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $23.49 / $42.61	Professional	TC	$17.32	$23.49	$42.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $32.34 / $32.34	Professional		$13.00	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $36.86 / $54.98	Professional		$30.44	$36.86	$54.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $16.54 / $21.87	Professional	26	$12.84	$16.54	$21.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.54 / $19.75 / $29.34	Professional	TC	$16.54	$19.75	$29.34