Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $14.99 / $18.00	Facility	26	$13.15	$14.99	$18.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.13 / $43.90 / $120.14	Facility	TC	$35.13	$43.90	$120.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $50.07 / $89.00	Professional		$43.99	$50.07	$89.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $13.69 / $28.00	Professional	26	$12.43	$13.69	$28.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $35.13 / $49.10	Professional	TC	$30.85	$35.13	$49.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $42.25 / $73.14	Professional		$38.95	$42.25	$73.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $11.88 / $19.95	Professional	26	$10.43	$11.88	$19.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.37 / $31.37 / $31.37	Professional	TC	$31.37	$31.37	$31.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.05 / $59.93 / $82.70	Professional		$44.05	$59.93	$82.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.71 / $19.39 / $26.77	Professional	26	$14.71	$19.39	$26.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $66.06 / $89.89 / $124.05	Professional	50	$66.06	$89.89	$124.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $40.54 / $55.94	Professional	TC	$29.34	$40.54	$55.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.78 / $42.48 / $63.39	Professional		$13.78	$42.48	$63.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.76 / $58.11 / $99.57	Professional		$45.76	$58.11	$99.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $17.89 / $27.95	Professional	26	$13.46	$17.89	$27.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.35 / $40.83 / $68.00	Professional	TC	$32.35	$40.83	$68.00
United Facility/Professional Professional Modifier Low / Median / High Price $44.71 / $52.30 / $92.23	Professional		$44.71	$52.30	$92.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.30 / $26.75	Professional	26	$13.49	$16.30	$26.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $37.34 / $64.56	Professional	TC	$31.00	$37.34	$64.56