Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.54 / $47.54 / $47.54	Facility		$47.54	$47.54	$47.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.69 / $16.69 / $16.69	Facility	26	$16.69	$16.69	$16.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $66.20 / $117.93	Professional		$47.54	$66.20	$117.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.29 / $23.19 / $34.17	Professional	26	$16.29	$23.19	$34.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $43.02 / $83.76	Professional	TC	$30.85	$43.02	$83.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $25.25 / $36.42	Professional	26	$10.18	$25.25	$36.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.38 / $28.32 / $66.70	Professional		$16.38	$28.32	$66.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $9.50 / $39.76	Professional	26	$9.50	$9.50	$39.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.02 / $7.74 / $29.64	Professional	TC	$6.02	$7.74	$29.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $57.61 / $85.89	Facility		$24.55	$57.61	$85.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.40 / $49.57 / $85.89	Professional		$23.40	$49.57	$85.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.80 / $127.80 / $127.80	Facility		$127.80	$127.80	$127.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.15 / $47.15 / $47.15	Facility	26	$47.15	$47.15	$47.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $67.25 / $111.22	Professional		$31.17	$67.25	$111.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $32.02 / $51.03	Professional	26	$10.29	$32.02	$51.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $32.29 / $74.73	Professional	TC	$19.76	$32.29	$74.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $51.15 / $63.16 / $97.16	Professional		$51.15	$63.16	$97.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $25.77 / $42.76	Professional	26	$13.94	$25.77	$42.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $37.78 / $68.67	Professional	TC	$25.37	$37.78	$68.67