Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.34 / $10.38 / $16.95	Facility	26	$10.34	$10.38	$16.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $38.89 / $167.00	Professional		$28.60	$38.89	$167.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $13.66 / $25.76	Professional	26	$10.06	$13.66	$25.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $21.58 / $34.51	Professional	TC	$18.28	$21.58	$34.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $12.05 / $14.70	Professional	26	$8.77	$12.05	$14.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $32.81 / $42.31	Professional		$27.88	$32.81	$42.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.89 / $14.13 / $18.20	Professional	26	$11.89	$14.13	$18.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $18.68 / $25.17	Professional	TC	$15.87	$18.68	$25.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.06 / $20.41 / $37.34	Professional		$11.06	$20.41	$37.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.33 / $43.85 / $68.59	Professional		$29.33	$43.85	$68.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $18.28 / $29.55	Professional	26	$11.25	$18.28	$29.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.78 / $27.95 / $42.86	Professional	TC	$19.78	$27.95	$42.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $32.34 / $32.34	Professional		$12.09	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $38.43 / $70.13	Professional		$32.52	$38.43	$70.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.30 / $16.48 / $28.36	Professional	26	$13.30	$16.48	$28.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.92 / $23.45 / $41.98	Professional	TC	$18.92	$23.45	$41.98