Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $14.13 / $19.95	Facility	26	$10.47	$14.13	$19.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $57.54 / $457.09	Facility	TC	$31.62	$57.54	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $57.54 / $165.96	Professional		$22.91	$57.54	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $18.62 / $58.88	Professional	26	$10.00	$18.62	$58.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $123.03 / $223.87	Professional	50	$40.74	$123.03	$223.87
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 / $43.65 / $89.13	Professional	TC	$28.18	$43.65	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $91.20	Professional		$30.90	$38.90	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $19.95	Professional	26	$8.13	$11.48	$19.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $63.10 / $131.83	Professional	50	$45.71	$63.10	$131.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $36.31 / $74.13	Professional	TC	$27.54	$36.31	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $37.15 / $66.07	Professional		$33.88	$37.15	$66.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.02 / $21.38	Professional	26	$11.22	$12.02	$21.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $56.23 / $100.00	Professional	50	$51.29	$56.23	$100.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $25.70 / $44.67	Professional	TC	$22.91	$25.70	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $33.88 / $54.95	Professional		$11.22	$33.88	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $17.78	Facility	26	$2.69	$12.59	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	TC	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $223.87	Professional		$34.67	$56.23	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $18.20 / $53.70	Professional	26	$10.47	$18.20	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $47.86 / $169.82	Professional	TC	$26.30	$47.86	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $32.36 / $33.11	Professional		$16.98	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $66.07	Professional		$32.36	$41.69	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.75 / $18.62	Professional	26	$9.77	$11.75	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $46.77	Professional	TC	$22.91	$29.51	$46.77