Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.84 / $263.25 / $391.55	Facility		$43.84	$263.25	$391.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.62 / $8.55 / $14.93	Facility	26	$7.62	$8.55	$14.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.75 / $181.94 / $355.79	Facility	TC	$14.75	$181.94	$355.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $23.96 / $82.14	Professional		$19.14	$23.96	$82.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.05 / $9.50 / $34.00	Professional	26	$8.05	$9.50	$34.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $15.27 / $28.45	Professional	TC	$10.66	$15.27	$28.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.63 / $22.87 / $22.87	Professional		$20.63	$22.87	$22.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $9.46 / $10.53	Professional	26	$6.45	$9.46	$10.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.55 / $12.55 / $12.55	Professional	TC	$12.55	$12.55	$12.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $71.00 / $79.00	Facility		$63.00	$71.00	$79.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.30 / $18.30 / $28.74	Professional		$18.30	$18.30	$28.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.82 / $10.97	Professional	26	$7.59	$8.82	$10.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.48 / $9.48 / $17.91	Professional	TC	$9.48	$9.48	$17.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.96 / $19.93 / $33.15	Facility		$8.96	$19.93	$33.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $17.68 / $32.02	Professional		$8.94	$17.68	$32.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $29.01 / $163.03	Facility		$29.01	$29.01	$163.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.67 / $28.25 / $46.20	Professional		$19.67	$28.25	$46.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $12.37 / $20.55	Professional	26	$8.66	$12.37	$20.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.90 / $15.62 / $28.30	Professional	TC	$10.90	$15.62	$28.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.12 / $32.34 / $32.34	Professional		$8.12	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $18.22 / $23.38 / $36.22	Professional		$18.22	$23.38	$36.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $9.84 / $14.07	Professional	26	$8.34	$9.84	$14.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.51 / $14.58 / $22.14	Professional	TC	$9.51	$14.58	$22.14