Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.92 / $215.65 / $411.64	Facility		$71.92	$215.65	$411.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $11.03 / $12.36	Facility	26	$9.67	$11.03	$12.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.60 / $71.97 / $277.87	Facility	TC	$20.60	$71.97	$277.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $31.55 / $64.00	Professional		$27.58	$31.55	$64.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $10.14 / $25.62	Professional	26	$9.49	$10.14	$25.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $21.39 / $36.08	Professional	TC	$17.96	$21.39	$36.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $30.39 / $48.62	Professional		$24.32	$30.39	$48.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $9.27 / $14.78	Professional	26	$7.73	$9.27	$14.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $31.11 / $31.11	Professional	TC	$22.06	$31.11	$31.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.46 / $187.82 / $200.00	Facility		$28.46	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $32.33 / $44.11	Professional		$27.95	$32.33	$44.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $12.65 / $19.54	Professional	26	$10.46	$12.65	$19.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $18.00 / $27.90	Professional	TC	$17.39	$18.00	$27.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.30 / $24.89 / $41.03	Facility		$10.30	$24.89	$41.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.14 / $23.85 / $39.51	Professional		$10.14	$23.85	$39.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.65 / $200.00 / $200.00	Facility		$37.65	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $37.44 / $66.70	Professional		$28.64	$37.44	$66.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $12.80 / $20.19	Professional	26	$9.93	$12.80	$20.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $23.85 / $45.26	Professional	TC	$18.88	$23.85	$45.26
United Facility/Professional Professional Modifier Low / Median / High Price $28.22 / $33.20 / $58.77	Professional		$28.22	$33.20	$58.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $11.85 / $20.05	Professional	26	$9.66	$11.85	$20.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $22.01 / $38.59	Professional	TC	$18.03	$22.01	$38.59