Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.43 / $12.75 / $20.00	Facility	26	$11.43	$12.75	$20.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $55.47 / $102.70	Professional		$48.44	$55.47	$102.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $12.80 / $20.70	Professional	26	$12.20	$12.80	$20.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.40 / $41.12 / $82.01	Professional	TC	$36.40	$41.12	$82.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $15.55 / $20.23	Professional	26	$9.86	$15.55	$20.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.29 / $40.29 / $40.29	Professional	TC	$40.29	$40.29	$40.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.46 / $47.85 / $69.59	Professional		$46.46	$47.85	$69.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $14.41 / $18.69	Professional	26	$12.84	$14.41	$18.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.69 / $71.77 / $104.38	Professional	50	$69.69	$71.77	$104.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.46 / $33.43 / $50.37	Professional	TC	$32.46	$33.43	$50.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.68 / $46.33 / $73.84	Professional		$13.68	$46.33	$73.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $69.56 / $107.05	Professional		$50.13	$69.56	$107.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $19.36 / $32.22	Professional	26	$13.07	$19.36	$32.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.94 / $50.76 / $75.78	Professional	TC	$36.94	$50.76	$75.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $32.34 / $40.00	Professional		$27.95	$32.34	$40.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.02 / $55.48 / $79.31	Professional		$46.02	$55.48	$79.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $15.48 / $22.08	Professional	26	$12.52	$15.48	$22.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.21 / $40.44 / $59.88	Professional	TC	$32.21	$40.44	$59.88