Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $38.84 / $41.33	Facility	26	$32.36	$38.84	$41.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.09 / $98.84 / $286.50	Professional		$87.09	$98.84	$286.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.99 / $33.56 / $46.70	Professional	26	$30.99	$33.56	$46.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.70 / $236.31 / $632.00	Professional	50	$46.70	$236.31	$632.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.05 / $65.48 / $102.96	Professional	TC	$57.05	$65.48	$102.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $74.58 / $80.59	Professional		$72.45	$74.58	$80.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.83 / $38.75 / $72.65	Professional	26	$25.83	$38.75	$72.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $108.69 / $114.37 / $157.72	Professional	50	$108.69	$114.37	$157.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.92 / $95.92 / $135.22	Professional	TC	$95.92	$95.92	$135.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.79 / $100.14 / $145.56	Professional		$83.79	$100.14	$145.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.55 / $35.38 / $50.23	Professional	26	$30.55	$35.38	$50.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.68 / $150.21 / $213.29	Professional	50	$125.68	$150.21	$213.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.24 / $64.76 / $96.94	Professional	TC	$53.24	$64.76	$96.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.56 / $72.12 / $120.11	Professional		$34.56	$72.12	$120.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.72 / $39.72 / $39.72	Facility	26	$39.72	$39.72	$39.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.05 / $128.90 / $216.88	Professional		$97.05	$128.90	$216.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.43 / $43.84 / $68.29	Professional	26	$33.43	$43.84	$68.29
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.68 / $138.68 / $157.99	Professional	50	$138.68	$138.68	$157.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.47 / $83.81 / $140.26	Professional	TC	$62.47	$83.81	$140.26
United Facility/Professional Professional Modifier Low / Median / High Price $92.64 / $111.93 / $214.58	Professional		$92.64	$111.93	$214.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $38.17 / $65.83	Professional	26	$31.59	$38.17	$65.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.39 / $72.28 / $124.46	Professional	TC	$60.39	$72.28	$124.46