Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.27 / $11.71 / $17.34	Facility	26	$10.27	$11.71	$17.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.57 / $109.09 / $343.41	Facility	TC	$31.57	$109.09	$343.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.44 / $43.79 / $96.00	Professional		$21.44	$43.79	$96.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.75 / $26.84	Professional	26	$9.77	$10.75	$26.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.20 / $128.19 / $176.00	Professional	50	$41.20	$128.19	$176.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.60 / $21.16 / $26.40	Professional	52	$17.60	$21.16	$26.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $33.09 / $68.28	Professional	TC	$27.87	$33.09	$68.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $37.08 / $68.19	Professional		$34.10	$37.08	$68.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $11.49 / $15.39	Professional	26	$8.19	$11.49	$15.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $51.15 / $76.72 / $102.29	Professional	50	$51.15	$76.72	$102.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.46 / $48.56 / $49.85	Professional	TC	$40.46	$48.56	$49.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $48.17 / $73.55	Professional		$34.22	$48.17	$73.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $14.60 / $20.60	Professional	26	$11.28	$14.60	$20.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.33 / $72.25 / $110.33	Professional	50	$51.33	$72.25	$110.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.69 / $32.00 / $53.88	Professional	TC	$22.69	$32.00	$53.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.77 / $37.45 / $55.41	Professional		$10.77	$37.45	$55.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $12.66	Facility	26	$12.66	$12.66	$12.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.63 / $40.63 / $40.63	Facility	TC	$40.63	$40.63	$40.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $50.84 / $94.38	Professional		$36.54	$50.84	$94.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.17 / $14.28 / $23.47	Professional	26	$10.17	$14.28	$23.47
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.72 / $53.72 / $61.21	Professional	50	$53.72	$53.72	$61.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.74 / $34.49 / $71.40	Professional	TC	$25.74	$34.49	$71.40
United Facility/Professional Professional Modifier Low / Median / High Price $34.49 / $43.51 / $75.45	Professional		$34.49	$43.51	$75.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $12.99 / $20.60	Professional	26	$10.24	$12.99	$20.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.03 / $32.68 / $57.62	Professional	TC	$25.03	$32.68	$57.62