Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $34.67 / $50.12	Facility	26	$30.90	$34.67	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $70.79 / $194.98	Professional		$30.90	$70.79	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $45.71 / $117.49	Professional	26	$19.95	$45.71	$117.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $69.18 / $70.79	Professional	50	$36.31	$69.18	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $28.18 / $70.79	Professional	TC	$7.94	$28.18	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $53.70 / $120.23	Professional		$41.69	$53.70	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $58.88	Professional	26	$24.55	$33.88	$58.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.51 / $58.88	Professional	TC	$21.88	$29.51	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.88 / $46.77	Professional		$24.55	$33.88	$46.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.91 / $31.62	Professional	26	$16.60	$22.91	$31.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $50.12 / $70.79	Professional	50	$37.15	$50.12	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $10.23 / $13.18	Professional	TC	$7.94	$10.23	$13.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.02 / $74.13	Professional		$29.51	$38.02	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $53.70	Facility	26	$7.94	$37.15	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $302.00	Professional		$31.62	$57.54	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.90 / $151.36	Professional	26	$22.91	$38.90	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $28.18 / $147.91	Professional	TC	$10.72	$28.18	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $32.36 / $33.11	Professional		$17.38	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $81.28	Professional		$30.20	$46.77	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $39.81	Professional	26	$19.95	$23.99	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $19.50 / $43.65	Professional	TC	$9.77	$19.50	$43.65