Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.07 / $12.39 / $19.38	Facility	26	$12.07	$12.39	$19.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.73 / $108.50 / $210.59	Professional		$74.73	$108.50	$210.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $12.60 / $28.05	Professional	26	$11.32	$12.60	$28.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $36.15 / $38.03 / $229.70	Professional	52	$36.15	$38.03	$229.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.89 / $85.34 / $131.53	Professional	TC	$63.89	$85.34	$131.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $70.55 / $78.41	Professional		$39.00	$70.55	$78.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $9.50 / $13.70	Professional	26	$7.01	$9.50	$13.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.83 / $69.91 / $69.91	Professional	TC	$65.83	$69.91	$69.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.50 / $91.74 / $114.99	Professional		$73.50	$91.74	$114.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $11.43 / $19.09	Professional	26	$9.71	$11.43	$19.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.22 / $80.30 / $102.47	Professional	TC	$60.22	$80.30	$102.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.06 / $68.54 / $98.77	Professional		$12.06	$68.54	$98.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.31 / $122.14 / $201.82	Professional		$74.31	$122.14	$201.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $17.27 / $25.20	Professional	26	$11.42	$17.27	$25.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.39 / $106.79 / $177.94	Professional	TC	$65.39	$106.79	$177.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $50.92	Professional		$32.34	$32.34	$50.92
United Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $111.00 / $161.01	Professional		$80.20	$111.00	$161.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $14.88 / $25.50	Professional	26	$10.98	$14.88	$25.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.41 / $93.59 / $138.28	Professional	TC	$67.41	$93.59	$138.28