Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.64 / $11.24 / $19.57	Facility	26	$9.64	$11.24	$19.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.49 / $50.72 / $449.55	Facility	TC	$28.49	$50.72	$449.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $51.84 / $200.00	Professional		$25.37	$51.84	$200.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $14.41 / $49.12	Professional	26	$10.02	$14.41	$49.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $84.72 / $145.08 / $382.50	Professional	50	$84.72	$145.08	$382.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.07 / $21.18 / $22.25	Professional	52	$19.07	$21.18	$22.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $33.09 / $69.02	Professional	TC	$27.87	$33.09	$69.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $51.48 / $51.48	Professional		$34.10	$51.48	$51.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $11.15 / $16.91	Professional	26	$8.19	$11.15	$16.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $68.26 / $86.48 / $86.48	Professional	50	$68.26	$86.48	$86.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.29 / $30.93 / $30.93	Professional	TC	$26.29	$30.93	$30.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $37.27 / $60.98	Professional		$31.68	$37.27	$60.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $11.88 / $19.05	Professional	26	$9.88	$11.88	$19.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $55.90 / $91.47	Professional	50	$47.52	$55.90	$91.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $25.65 / $43.40	Professional	TC	$21.80	$25.65	$43.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.33 / $35.57 / $57.65	Professional		$11.33	$35.57	$57.65
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 $36.45 / $52.86 / $90.65	Professional		$36.45	$52.86	$90.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $15.87 / $24.16	Professional	26	$10.55	$15.87	$24.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.39 / $38.67 / $68.50	Professional	TC	$26.39	$38.67	$68.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.47 / $32.34 / $32.34	Professional		$17.47	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $42.80 / $62.15	Professional		$32.86	$42.80	$62.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $11.99 / $17.32	Professional	26	$9.59	$11.99	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $31.57 / $48.29	Professional	TC	$22.80	$31.57	$48.29