Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.36 / $21.78 / $42.56	Facility		$18.36	$21.78	$42.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.56 / $3.04 / $13.21	Facility	26	$2.56	$3.04	$13.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.36 / $30.06 / $46.26	Professional		$18.36	$30.06	$46.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.56 / $3.91 / $10.64	Professional	26	$2.56	$3.91	$10.64
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.18 / $9.44 / $14.51	Professional	52	$9.18	$9.44	$14.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $25.10 / $39.43	Professional	TC	$16.17	$25.10	$39.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $27.72 / $27.72	Professional		$27.72	$27.72	$27.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.38 / $24.43 / $64.68	Professional		$18.38	$24.43	$64.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.78 / $3.67 / $14.50	Professional	26	$2.78	$3.67	$14.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $27.57 / $36.65 / $97.31	Professional	50	$27.57	$36.65	$97.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $20.54 / $52.36	Professional	TC	$15.59	$20.54	$52.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.12 / $19.94 / $29.64	Facility		$3.12	$19.94	$29.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.07 / $19.57 / $27.92	Professional		$3.07	$19.57	$27.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $28.48	Facility		$26.10	$26.10	$28.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.66 / $41.64 / $75.81	Professional		$20.66	$41.64	$75.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.97 / $10.07 / $19.23	Professional	26	$2.97	$10.07	$19.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $31.45 / $60.56	Professional	TC	$17.66	$31.45	$60.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $32.34 / $32.34	Professional		$3.06	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $30.52 / $51.07	Professional		$19.47	$30.52	$51.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.76 / $3.93 / $13.16	Professional	26	$2.76	$3.93	$13.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.50 / $22.71 / $36.09	Professional	TC	$15.50	$22.71	$36.09