Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $15.49 / $21.38	Facility	26	$11.75	$15.49	$21.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $74.13 / $213.80	Professional		$48.98	$74.13	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.50 / $51.29	Professional	26	$10.96	$19.50	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $45.71 / $81.28	Professional	TC	$38.02	$45.71	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $104.71	Professional		$46.77	$60.26	$104.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.79 / $20.89	Professional	26	$10.96	$14.79	$20.89
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $13.80 / $13.80 / $13.80	Professional	52	$13.80	$13.80	$13.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $47.86 / $63.10	Professional		$40.74	$47.86	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $11.75 / $15.49	Professional	26	$10.00	$11.75	$15.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $36.31 / $47.86	Professional	TC	$30.90	$36.31	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $45.71 / $69.18	Professional		$12.02	$45.71	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.88 / $13.49 / $19.05	Facility	26	$2.88	$13.49	$19.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $77.62 / $263.03	Professional		$48.98	$77.62	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $17.78 / $54.95	Professional	26	$11.22	$17.78	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $58.88 / $208.93	Professional	TC	$37.15	$58.88	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $43.65	Professional		$10.72	$32.36	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $57.54 / $95.50	Professional		$45.71	$57.54	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $22.91	Professional	26	$10.96	$13.80	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $43.65 / $70.79	Professional	TC	$34.67	$43.65	$70.79