Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.81 / $6.81 / $10.25	Facility	26	$6.81	$6.81	$10.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $12.60 / $17.48 / $44.00	Facility	TC	$12.60	$17.48	$44.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $20.92 / $25.94	Professional		$17.89	$20.92	$25.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.10 / $9.60	Professional	26	$6.42	$7.10	$9.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.78 / $13.83 / $18.44	Professional	TC	$11.78	$13.83	$18.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.43 / $17.19 / $17.19	Professional		$15.43	$17.19	$17.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.56 / $8.16 / $10.50	Professional	26	$5.56	$8.16	$10.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.64 / $25.81 / $40.00	Professional		$20.64	$25.81	$40.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $10.00 / $13.80	Professional	26	$8.00	$10.00	$13.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $30.97 / $38.71 / $60.00	Professional	50	$30.97	$38.71	$60.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.04 / $15.81 / $25.36	Professional	TC	$13.04	$15.81	$25.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.14 / $15.22 / $25.32	Professional		$7.14	$15.22	$25.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.35 / $29.97 / $51.25	Professional		$19.35	$29.97	$51.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.87 / $9.75 / $15.92	Professional	26	$6.87	$9.75	$15.92
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $35.06	Professional	50	$31.05	$31.05	$35.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.71 / $20.20 / $35.82	Professional	TC	$12.71	$20.20	$35.82
United Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $25.23 / $46.16	Professional		$19.84	$25.23	$46.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.16 / $13.67	Professional	26	$6.92	$8.16	$13.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $16.20 / $25.61	Professional	TC	$12.30	$16.20	$25.61