Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.96 / $40.78 / $56.21	Facility	26	$39.96	$40.78	$56.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.28 / $63.24 / $137.84	Professional		$49.28	$63.24	$137.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $39.97 / $64.90	Professional	26	$24.78	$39.97	$64.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.64 / $12.29 / $89.34	Professional	TC	$9.64	$12.29	$89.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.94 / $51.46 / $58.64	Professional		$38.94	$51.46	$58.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $31.90 / $67.06	Professional	26	$20.05	$31.90	$67.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.07 / $110.49 / $156.88	Professional		$92.07	$110.49	$156.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $28.02 / $42.03	Professional	26	$24.20	$28.02	$42.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $138.10 / $165.73 / $235.34	Professional	50	$138.10	$165.73	$235.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.93 / $82.47 / $117.10	Professional	TC	$67.93	$82.47	$117.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.99 / $45.93 / $64.06	Professional		$9.99	$45.93	$64.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.32 / $49.32 / $49.32	Facility	26	$49.32	$49.32	$49.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.08 / $125.88 / $223.83	Professional		$56.08	$125.88	$223.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $41.10 / $71.78	Professional	26	$32.40	$41.10	$71.78
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.21 / $115.21 / $131.31	Professional	50	$115.21	$115.21	$131.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.86 / $86.79 / $137.88	Professional	TC	$10.86	$86.79	$137.88
United Facility/Professional Professional Modifier Low / Median / High Price $68.76 / $110.23 / $179.60	Professional		$68.76	$110.23	$179.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.30 / $32.58 / $58.75	Professional	26	$27.30	$32.58	$58.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $75.06 / $130.93	Professional	TC	$39.79	$75.06	$130.93