Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.51 / $33.95 / $61.41	Facility	26	$30.51	$33.95	$61.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.63 / $98.70 / $183.87	Professional		$85.63	$98.70	$183.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $33.90 / $53.89	Professional	26	$30.51	$33.90	$53.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $119.27 / $661.50 / $749.61	Professional	50	$119.27	$661.50	$749.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.47 / $66.03 / $116.77	Professional	TC	$56.47	$66.03	$116.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.72 / $70.15 / $80.81	Professional		$66.72	$70.15	$80.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.83 / $38.94 / $53.54	Professional	26	$25.83	$38.94	$53.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.08 / $100.08 / $105.23	Professional	50	$100.08	$100.08	$105.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.92 / $95.92 / $95.92	Professional	TC	$95.92	$95.92	$95.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.79 / $85.40 / $131.16	Professional		$83.79	$85.40	$131.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.55 / $30.76 / $46.63	Professional	26	$30.55	$30.76	$46.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.68 / $128.10 / $193.23	Professional	50	$125.68	$128.10	$193.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.24 / $54.64 / $83.45	Professional	TC	$53.24	$54.64	$83.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.52 / $65.91 / $125.68	Professional		$35.52	$65.91	$125.68
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 $91.81 / $136.24 / $227.65	Professional		$91.81	$136.24	$227.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.15 / $47.98 / $82.94	Professional	26	$31.15	$47.98	$82.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.86 / $86.94 / $144.71	Professional	TC	$59.86	$86.94	$144.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $85.07	Professional		$32.34	$32.34	$85.07
United Facility/Professional Professional Modifier Low / Median / High Price $88.66 / $109.84 / $155.43	Professional		$88.66	$109.84	$155.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.18 / $39.65 / $56.75	Professional	26	$32.18	$39.65	$56.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.01 / $70.30 / $98.35	Professional	TC	$58.01	$70.30	$98.35