Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $43.65 / $56.23	Facility	26	$32.36	$43.65	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $295.12	Professional		$69.18	$114.82	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $45.71 / $144.54	Professional	26	$28.84	$45.71	$144.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $263.03 / $724.44	Professional	50	$85.11	$263.03	$724.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $69.18 / $151.36	Professional	TC	$56.23	$69.18	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $100.00	Professional		$66.07	$81.28	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $39.81 / $72.44	Professional	26	$26.30	$39.81	$72.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $125.89 / $158.49	Professional	50	$112.20	$125.89	$158.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $134.90	Professional	TC	$48.98	$74.13	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $162.18	Professional		$83.18	$100.00	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $35.48 / $56.23	Professional	26	$30.90	$35.48	$56.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $151.36 / $239.88	Professional	50	$125.89	$151.36	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $64.57 / $104.71	Professional	TC	$53.70	$64.57	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $70.79 / $120.23	Professional		$35.48	$70.79	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $208.93	Professional		$83.18	$128.82	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $44.67 / $70.79	Professional	26	$28.84	$44.67	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $83.18 / $138.04	Professional	TC	$56.23	$83.18	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $112.20 / $169.82	Professional		$91.20	$112.20	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $58.88	Professional	26	$30.90	$39.81	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $72.44 / $112.20	Professional	TC	$57.54	$72.44	$112.20