Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $281.84 / $645.65	Facility		$37.15	$281.84	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $12.59 / $19.05	Facility	26	$10.47	$12.59	$19.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $45.71 / $467.74	Facility	TC	$25.70	$45.71	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $162.18	Professional		$33.88	$53.70	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.49 / $38.02	Professional	26	$9.33	$15.49	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $34.67 / $58.88	Professional	TC	$22.91	$34.67	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $31.62 / $60.26	Professional		$24.55	$31.62	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $19.05	Professional	26	$7.94	$10.96	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $48.98	Professional	TC	$19.50	$26.92	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $36.31 / $63.10	Professional		$32.36	$36.31	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.02 / $20.42	Professional	26	$11.22	$12.02	$20.42
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 $10.96 / $33.11 / $52.48	Facility		$10.96	$33.11	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $28.18 / $46.77	Professional		$10.96	$28.18	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $61.66 / $61.66	Facility		$28.18	$61.66	$61.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	TC	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $186.21	Professional		$32.36	$50.12	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $18.20 / $53.70	Professional	26	$10.23	$18.20	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $39.81 / $134.90	Professional	TC	$22.91	$39.81	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $32.36 / $33.11	Professional		$16.22	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $56.23	Professional		$30.90	$38.02	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.75 / $18.62	Professional	26	$9.77	$11.75	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $38.02	Professional	TC	$20.89	$25.70	$38.02