Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $199.53 / $346.74	Facility		$38.02	$199.53	$346.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $9.12 / $13.49	Facility	26	$8.13	$9.12	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.49 / $239.88 / $354.81	Facility	TC	$15.49	$239.88	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.18 / $87.10	Professional		$17.78	$28.18	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $37.15	Professional	26	$7.94	$9.77	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $16.98 / $32.36	Professional	TC	$10.72	$16.98	$32.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $23.44 / $46.77	Professional		$16.98	$23.44	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $16.22	Professional	26	$6.46	$9.12	$16.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $16.22 / $21.88	Professional	TC	$13.18	$16.22	$21.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $26.92	Professional		$18.20	$18.20	$26.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $8.91 / $11.48	Professional	26	$8.91	$8.91	$11.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $9.55 / $15.14	Professional	TC	$9.55	$9.55	$15.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $19.95 / $33.88	Facility		$8.91	$19.95	$33.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $16.98 / $30.90	Professional		$8.91	$16.98	$30.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $35.48 / $40.74	Facility		$16.98	$35.48	$40.74
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 $4.07 / $19.05 / $26.92	Facility	TC	$4.07	$19.05	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $34.67 / $120.23	Professional		$19.50	$34.67	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $15.85 / $40.74	Professional	26	$8.71	$15.85	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $19.50 / $81.28	Professional	TC	$10.96	$19.50	$81.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $32.36 / $33.11	Professional		$7.76	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.39 / $36.31	Professional		$18.20	$22.39	$36.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $15.14	Professional	26	$8.13	$10.00	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $13.18 / $21.88	Professional	TC	$9.55	$13.18	$21.88