Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.78 / $213.50 / $393.65	Facility		$33.78	$213.50	$393.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.11 / $10.19 / $18.46	Facility	26	$9.11	$10.19	$18.46
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.01 / $183.14 / $367.94	Facility	TC	$20.01	$183.14	$367.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $36.36 / $129.60	Professional		$27.74	$36.36	$129.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $13.82 / $43.35	Professional	26	$9.66	$13.82	$43.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $21.27 / $43.69	Professional	TC	$18.64	$21.27	$43.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.07 / $32.76 / $44.33	Professional		$23.07	$32.76	$44.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $10.29 / $12.58	Professional	26	$7.73	$10.29	$12.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $19.87 / $25.83	Professional	TC	$16.89	$19.87	$25.83
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 $27.95 / $27.95 / $38.29	Professional		$27.95	$27.95	$38.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $10.54 / $13.99	Professional	26	$8.94	$10.54	$13.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.39 / $17.39 / $26.10	Professional	TC	$17.39	$17.39	$26.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.70 / $26.82 / $42.85	Facility		$10.70	$26.82	$42.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $22.85 / $41.37	Professional		$11.11	$22.85	$41.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.65 / $37.65 / $163.03	Facility		$37.65	$37.65	$163.03
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 $28.56 / $39.96 / $64.11	Professional		$28.56	$39.96	$64.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.41 / $14.81 / $24.58	Professional	26	$10.41	$14.81	$24.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.18 / $26.56 / $39.52	Professional	TC	$19.18	$26.56	$39.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.91 / $32.34 / $32.34	Professional		$14.91	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $33.20 / $49.80	Professional		$27.56	$33.20	$49.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.96 / $19.46	Professional	26	$9.77	$11.96	$19.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.46 / $22.01 / $31.94	Professional	TC	$17.46	$22.01	$31.94