Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.35 / $89.00 / $477.00	Facility		$23.35	$89.00	$477.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.12 / $5.49 / $11.13	Facility	26	$5.12	$5.49	$11.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.72 / $38.15 / $59.79	Professional		$21.72	$38.15	$59.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.92 / $5.40 / $10.38	Professional	26	$4.92	$5.40	$10.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $28.10 / $53.33	Professional	TC	$16.80	$28.10	$53.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $29.49	Professional		$19.95	$19.95	$29.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.65 / $6.32 / $11.25	Professional	26	$4.65	$6.32	$11.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $22.90 / $34.11	Professional		$20.50	$22.90	$34.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $13.01 / $16.23	Professional	26	$8.58	$13.01	$16.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.24 / $7.86 / $26.33	Professional	TC	$6.24	$7.86	$26.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.57 / $30.66 / $40.47	Facility		$7.57	$30.66	$40.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.38 / $28.26 / $40.47	Professional		$7.38	$28.26	$40.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.45 / $74.45 / $74.45	Facility		$74.45	$74.45	$74.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.31 / $9.31 / $9.31	Facility	26	$9.31	$9.31	$9.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.96 / $41.28 / $75.00	Professional		$14.96	$41.28	$75.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.21 / $8.28 / $16.28	Professional	26	$3.21	$8.28	$16.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.63 / $27.62 / $74.73	Professional	TC	$11.63	$27.62	$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 $26.29 / $34.54 / $56.93	Professional		$26.29	$34.54	$56.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $7.20 / $13.62	Professional	26	$6.11	$7.20	$13.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.58 / $29.02 / $48.36	Professional	TC	$20.58	$29.02	$48.36