Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.16 / $7.39 / $241.23	Facility	26	$6.16	$7.39	$241.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.71 / $33.26 / $97.82	Facility	TC	$27.71	$33.26	$97.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $36.38 / $72.00	Professional		$25.10	$36.38	$72.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $6.48 / $14.64	Professional	26	$5.83	$6.48	$14.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $12.30 / $12.30 / $49.00	Professional	50	$12.30	$12.30	$49.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.55 / $16.94 / $21.42	Professional	52	$12.55	$16.94	$21.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $28.19 / $54.85	Professional	TC	$22.57	$28.19	$54.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.47 / $38.46 / $60.00	Professional		$27.47	$38.46	$60.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.92 / $5.91 / $9.23	Professional	26	$4.92	$5.91	$9.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.54 / $42.29 / $43.45	Professional	TC	$33.54	$42.29	$43.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.04 / $34.47 / $66.14	Professional		$23.04	$34.47	$66.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.49 / $9.10 / $12.55	Professional	26	$5.49	$9.10	$12.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.56 / $51.73 / $99.22	Professional	50	$34.56	$51.73	$99.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.50 / $22.77 / $53.88	Professional	TC	$16.50	$22.77	$53.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $32.42 / $44.64	Professional		$6.46	$32.42	$44.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $35.72 / $75.11	Professional		$25.38	$35.72	$75.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $8.59 / $14.19	Professional	26	$6.09	$8.59	$14.19
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $49.70	Professional	50	$43.71	$43.71	$49.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $28.03 / $58.34	Professional	TC	$18.19	$28.03	$58.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.81 / $34.56 / $60.39	Professional		$25.81	$34.56	$60.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $7.33 / $12.53	Professional	26	$6.09	$7.33	$12.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $28.19 / $49.08	Professional	TC	$19.30	$28.19	$49.08