Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $63.10 / $316.23	Facility		$33.11	$63.10	$316.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $11.48 / $15.85	Facility	26	$8.51	$11.48	$15.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $36.31 / $47.86	Facility	TC	$23.99	$36.31	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $89.13	Professional		$28.84	$38.90	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.88 / $45.71	Professional	26	$7.08	$12.88	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.30 / $48.98	Professional	TC	$20.89	$26.30	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $26.92 / $69.18	Professional		$23.99	$26.92	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.77 / $15.85	Professional	26	$8.32	$9.77	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $58.88	Professional	TC	$41.69	$41.69	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $34.67 / $64.57	Professional		$33.88	$34.67	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.59 / $23.44	Professional	26	$11.75	$12.59	$23.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.88 / $41.69	Professional	TC	$21.38	$21.88	$41.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $30.20 / $43.65	Facility		$8.13	$30.20	$43.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $25.70 / $41.69	Professional		$8.91	$25.70	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $56.23 / $56.23	Facility		$26.30	$56.23	$56.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.31 / $29.51 / $42.66	Facility	TC	$6.31	$29.51	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.48 / $169.82	Professional		$32.36	$52.48	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $17.78 / $54.95	Professional	26	$9.55	$17.78	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $128.82	Professional	TC	$22.91	$40.74	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $32.36 / $33.11	Professional		$16.98	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $36.31 / $56.23	Professional		$30.20	$36.31	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.30 / $18.20	Professional	26	$9.77	$12.30	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $24.55 / $38.90	Professional	TC	$20.42	$24.55	$38.90