Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $37.56 / $76.20	Facility	26	$30.20	$37.56	$76.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.61 / $95.29 / $312.00	Professional		$49.61	$95.29	$312.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $39.97 / $66.53	Professional	26	$26.28	$39.97	$66.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.64 / $19.73 / $98.28	Professional	TC	$9.64	$19.73	$98.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.89 / $41.89 / $44.18	Professional		$41.89	$41.89	$44.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $37.65 / $51.92	Professional	26	$37.65	$37.65	$51.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.35 / $111.02 / $140.97	Professional		$87.35	$111.02	$140.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.77 / $30.46 / $42.86	Professional	26	$23.77	$30.46	$42.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $131.03 / $166.53 / $211.45	Professional	50	$131.03	$166.53	$211.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.91 / $82.47 / $102.83	Professional	TC	$62.91	$82.47	$102.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $44.52 / $68.64	Professional		$10.00	$44.52	$68.64
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 $54.93 / $131.97 / $216.78	Professional		$54.93	$131.97	$216.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $42.90 / $81.41	Professional	26	$30.31	$42.90	$81.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.59 / $92.77 / $152.38	Professional	TC	$10.59	$92.77	$152.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $78.37	Professional		$32.34	$32.34	$78.37
United Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $109.42 / $146.62	Professional		$65.59	$109.42	$146.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.57 / $32.65 / $53.51	Professional	26	$26.57	$32.65	$53.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $76.33 / $106.06	Professional	TC	$37.53	$76.33	$106.06