Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.33 / $51.48 / $78.14	Facility	26	$44.33	$51.48	$78.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $128.19 / $694.00	Professional		$84.00	$128.19	$694.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $51.90 / $147.24	Professional	26	$42.70	$51.90	$147.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $274.42 / $325.39 / $325.39	Professional	50	$274.42	$325.39	$325.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.17 / $48.29 / $85.15	Professional	TC	$40.17	$48.29	$85.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $107.76 / $127.88	Professional		$79.29	$107.76	$127.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.48 / $53.55 / $57.67	Professional	26	$51.48	$53.55	$57.67
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $161.63 / $161.63 / $161.63	Professional	50	$161.63	$161.63	$161.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.37 / $80.05 / $116.77	Professional		$64.37	$80.05	$116.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.21 / $43.16 / $62.16	Professional	26	$34.21	$43.16	$62.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.15 / $35.47 / $58.98	Professional	TC	$30.15	$35.47	$58.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.70 / $58.08 / $116.05	Professional		$41.70	$58.08	$116.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.51 / $50.51 / $50.51	Facility	26	$50.51	$50.51	$50.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.84 / $121.89 / $181.76	Professional		$84.84	$121.89	$181.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.09 / $65.22 / $95.63	Professional	26	$42.09	$65.22	$95.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.61 / $56.10 / $81.55	Professional	TC	$39.61	$56.10	$81.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $32.34 / $71.76	Professional		$30.93	$32.34	$71.76
United Facility/Professional Professional Modifier Low / Median / High Price $83.19 / $119.80 / $185.73	Professional		$83.19	$119.80	$185.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.06 / $57.56 / $92.62	Professional	26	$44.06	$57.56	$92.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.28 / $51.70 / $93.11	Professional	TC	$37.28	$51.70	$93.11