Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.83 / $6.93 / $11.87	Facility	26	$5.83	$6.93	$11.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.03 / $41.12 / $253.57	Facility	TC	$25.03	$41.12	$253.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $42.15 / $155.41	Professional		$27.79	$42.15	$155.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $8.52 / $31.68	Professional	26	$6.15	$8.52	$31.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.70 / $97.50 / $118.77	Professional	50	$61.70	$97.50	$118.77
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.29 / $17.14 / $18.77	Professional	52	$15.29	$17.14	$18.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $28.85 / $59.46	Professional	TC	$22.57	$28.85	$59.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.47 / $41.45 / $49.74	Professional		$27.47	$41.45	$49.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.92 / $6.15 / $8.06	Professional	26	$4.92	$6.15	$8.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $26.96 / $33.54	Professional	TC	$26.96	$26.96	$33.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $27.15 / $47.74	Professional		$22.63	$27.15	$47.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.49 / $6.65 / $11.47	Professional	26	$5.49	$6.65	$11.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.94 / $40.72 / $71.61	Professional	50	$33.94	$40.72	$71.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $21.50 / $37.14	Professional	TC	$15.66	$21.50	$37.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.85 / $31.00 / $46.42	Professional		$6.85	$31.00	$46.42
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 $26.65 / $40.20 / $72.51	Professional		$26.65	$40.20	$72.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $9.74 / $14.48	Professional	26	$6.38	$9.74	$14.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $30.55 / $56.81	Professional	TC	$19.55	$30.55	$56.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $32.34 / $32.34	Professional		$11.91	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $22.27 / $32.58 / $53.89	Professional		$22.27	$32.58	$53.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.78 / $7.28 / $10.83	Professional	26	$5.78	$7.28	$10.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.42 / $24.46 / $40.44	Professional	TC	$15.42	$24.46	$40.44