Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.88 / $61.66	Facility	26	$33.11	$33.88	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $436.52	Professional		$75.86	$107.15	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $109.65	Professional	26	$30.20	$40.74	$109.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $363.08 / $776.25	Professional	50	$67.61	$363.08	$776.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $70.79 / $123.03	Professional	TC	$54.95	$70.79	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $120.23	Professional		$56.23	$81.28	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $66.07	Professional	26	$25.70	$36.31	$66.07
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $123.03 / $275.42	Professional	50	$112.20	$123.03	$275.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $95.50 / $190.55	Professional	TC	$53.70	$95.50	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $125.89	Professional		$83.18	$85.11	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $43.65	Professional	26	$30.90	$30.90	$43.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $128.82 / $186.21	Professional	50	$125.89	$128.82	$186.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $54.95 / $79.43	Professional	TC	$53.70	$54.95	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $63.10 / $117.49	Professional		$34.67	$63.10	$117.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	26	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $478.63	Professional		$89.13	$144.54	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $52.48 / $162.18	Professional	26	$33.88	$52.48	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $97.72 / $316.23	Professional	TC	$63.10	$97.72	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $53.70	Professional		$32.36	$33.11	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $169.82	Professional		$89.13	$109.65	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $39.81 / $60.26	Professional	26	$32.36	$39.81	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $70.79 / $109.65	Professional	TC	$57.54	$70.79	$109.65