Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $13.73 / $19.11	Facility	26	$12.30	$13.73	$19.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.04 / $38.11 / $343.08	Facility	TC	$34.04	$38.11	$343.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $51.07 / $97.00	Professional		$44.27	$51.07	$97.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $14.02 / $33.95	Professional	26	$13.15	$14.02	$33.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.44 / $36.43 / $69.26	Professional	TC	$31.44	$36.43	$69.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $40.13 / $42.42	Professional		$39.01	$40.13	$42.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $13.08 / $17.00	Professional	26	$10.46	$13.08	$17.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.04 / $34.04 / $34.04	Professional	TC	$34.04	$34.04	$34.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.05 / $45.37 / $65.59	Professional		$44.05	$45.37	$65.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $15.15 / $19.64	Professional	26	$13.69	$15.15	$19.64
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $66.06 / $68.05 / $95.50	Professional	50	$66.06	$68.05	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $30.22 / $44.71	Professional	TC	$29.34	$30.22	$44.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.01 / $39.15 / $65.98	Professional		$15.01	$39.15	$65.98
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 $46.74 / $62.95 / $101.50	Professional		$46.74	$62.95	$101.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $20.46 / $33.88	Professional	26	$14.07	$20.46	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.67 / $45.65 / $67.62	Professional	TC	$32.67	$45.65	$67.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.27 / $32.34 / $37.93	Professional		$25.27	$32.34	$37.93
United Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $49.22 / $72.89	Professional		$43.87	$49.22	$72.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $16.68 / $23.21	Professional	26	$13.10	$16.68	$23.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.99 / $39.34 / $52.54	Professional	TC	$29.99	$39.34	$52.54