Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $20.42 / $26.92	Facility	26	$16.98	$20.42	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $69.18 / $251.19	Professional		$53.70	$69.18	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.39 / $83.18	Professional	26	$16.60	$22.39	$83.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $229.09 / $245.47	Professional	50	$28.84	$229.09	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $67.61	Professional	TC	$37.15	$43.65	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $109.65	Professional		$52.48	$69.18	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $33.88	Professional	26	$15.85	$20.89	$33.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $57.54 / $93.33	Professional		$45.71	$57.54	$93.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.05 / $30.20	Professional	26	$14.45	$19.05	$30.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $38.90 / $61.66	Professional	TC	$30.20	$38.90	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $44.67 / $72.44	Professional		$18.20	$44.67	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $120.23	Professional		$56.23	$72.44	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $22.91 / $38.90	Professional	26	$17.38	$22.91	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $48.98 / $87.10	Professional	TC	$38.90	$48.98	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $104.71	Professional		$52.48	$64.57	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.95 / $33.11	Professional	26	$15.85	$19.95	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $44.67 / $69.18	Professional	TC	$35.48	$44.67	$69.18