Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $13.80 / $18.62	Facility	26	$10.23	$13.80	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $50.12 / $436.52	Facility	TC	$31.62	$50.12	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $58.88 / $173.78	Professional		$21.38	$58.88	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $20.89 / $58.88	Professional	26	$10.00	$20.89	$58.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $128.82 / $263.03	Professional	50	$40.74	$128.82	$263.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $48.98 / $91.20	Professional	TC	$28.18	$48.98	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $39.81 / $72.44	Professional		$31.62	$39.81	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $19.95	Professional	26	$7.94	$8.91	$19.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $61.66 / $102.33	Professional	50	$48.98	$61.66	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.90 / $54.95	Professional	TC	$25.70	$38.90	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $81.28	Professional		$36.31	$51.29	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $22.91	Professional	26	$10.72	$14.45	$22.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $53.70 / $77.62 / $123.03	Professional	50	$53.70	$77.62	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $34.67 / $60.26	Professional	TC	$23.44	$34.67	$60.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $39.81 / $57.54	Professional		$11.22	$39.81	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $91.20	Professional		$34.67	$51.29	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.79 / $24.55	Professional	26	$9.55	$14.79	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $75.86	Professional	TC	$25.70	$37.15	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $43.65 / $72.44	Professional		$34.67	$43.65	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $20.42	Professional	26	$10.00	$12.02	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $31.62 / $52.48	Professional	TC	$24.55	$31.62	$52.48