Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.21 / $27.21 / $27.21	Facility		$27.21	$27.21	$27.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.52 / $13.52 / $13.52	Facility	26	$13.52	$13.52	$13.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $34.54 / $75.92	Professional		$27.21	$34.54	$75.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $15.62 / $24.76	Professional	26	$13.36	$15.62	$24.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.69 / $17.38 / $51.13	Professional	TC	$13.69	$17.38	$51.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.30 / $30.30 / $30.30	Professional		$30.30	$30.30	$30.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.83 / $14.83 / $14.83	Professional	26	$14.83	$14.83	$14.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $36.43 / $67.80	Professional		$28.87	$36.43	$67.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.16 / $18.07 / $23.80	Professional	26	$14.16	$18.07	$23.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.83 / $18.35 / $44.00	Professional	TC	$14.83	$18.35	$44.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.83 / $21.08 / $41.71	Facility		$14.83	$21.08	$41.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.71 / $21.07 / $41.41	Professional		$14.71	$21.07	$41.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.28 / $37.28 / $37.28	Facility		$37.28	$37.28	$37.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.95 / $17.95 / $17.95	Facility	26	$17.95	$17.95	$17.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $46.78 / $88.80	Professional		$26.70	$46.78	$88.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $20.57 / $29.79	Professional	26	$12.80	$20.57	$29.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.79 / $26.91 / $66.13	Professional	TC	$13.79	$26.91	$66.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.31 / $32.34 / $32.34	Professional		$14.31	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $26.15 / $38.81 / $59.09	Professional		$26.15	$38.81	$59.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $16.60 / $24.64	Professional	26	$12.78	$16.60	$24.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.52 / $19.78 / $35.33	Professional	TC	$13.52	$19.78	$35.33