Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $23.44 / $28.18	Facility	26	$17.78	$23.44	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $275.42	Professional		$54.95	$67.61	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $21.88 / $89.13	Professional	26	$16.22	$21.88	$89.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $199.53 / $199.53	Professional	50	$28.84	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $44.67 / $74.13	Professional	TC	$38.02	$44.67	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $123.03	Professional		$50.12	$58.88	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.91 / $24.55	Professional	26	$16.98	$22.91	$24.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $70.79	Professional		$42.66	$50.12	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $23.99	Professional	26	$14.45	$16.98	$23.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $46.77	Professional	TC	$28.18	$33.11	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $40.74 / $70.79	Professional		$18.20	$40.74	$70.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.37 / $20.42 / $29.51	Facility	26	$4.37	$20.42	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $95.50 / $281.84	Professional		$54.95	$95.50	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $29.51 / $85.11	Professional	26	$17.38	$29.51	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $66.07 / $194.98	Professional	TC	$37.15	$66.07	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $34.67	Professional		$15.49	$32.36	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $117.49	Professional		$51.29	$66.07	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.38 / $37.15	Professional	26	$16.60	$21.38	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $44.67 / $79.43	Professional	TC	$34.67	$44.67	$79.43