Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.61 / $14.07 / $25.01	Facility	26	$12.61	$14.07	$25.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.75 / $51.24 / $101.25	Professional		$45.75	$51.24	$101.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $14.01 / $22.06	Professional	26	$13.22	$14.01	$22.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.15 / $37.71 / $69.03	Professional	TC	$32.15	$37.71	$69.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $10.62 / $10.62	Professional	26	$10.62	$10.62	$10.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $52.86 / $68.06	Professional		$51.31	$52.86	$68.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $11.35 / $20.12	Professional	26	$10.81	$11.35	$20.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.40 / $40.50 / $52.23	Professional	TC	$36.40	$40.50	$52.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.50 / $20.99 / $68.09	Professional		$14.50	$20.99	$68.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $71.81 / $116.83	Professional		$47.97	$71.81	$116.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $21.32 / $34.08	Professional	26	$14.10	$21.32	$34.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.75 / $51.30 / $82.75	Professional	TC	$35.75	$51.30	$82.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $32.34 / $43.64	Professional		$30.91	$32.34	$43.64
United Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $53.02 / $77.34	Professional		$42.25	$53.02	$77.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $16.23 / $22.91	Professional	26	$12.13	$16.23	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.78 / $38.97 / $56.25	Professional	TC	$29.78	$38.97	$56.25