Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.63 / $328.25 / $570.02	Facility		$35.63	$328.25	$570.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.36 / $10.49 / $19.03	Facility	26	$9.36	$10.49	$19.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.47 / $45.64 / $339.63	Facility	TC	$24.47	$45.64	$339.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $43.24 / $157.00	Professional		$35.10	$43.24	$157.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $13.72 / $26.01	Professional	26	$9.98	$13.72	$26.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $28.39 / $54.42	Professional	TC	$24.25	$28.39	$54.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $38.50 / $51.99	Professional		$28.61	$38.50	$51.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $9.96 / $12.95	Professional	26	$7.97	$9.96	$12.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.30 / $24.69 / $30.71	Professional	TC	$21.30	$24.69	$30.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $34.36 / $54.45	Professional		$28.60	$34.36	$54.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $11.62 / $19.05	Professional	26	$9.86	$11.62	$19.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $22.03 / $36.96	Professional	TC	$18.73	$22.03	$36.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.07 / $33.33 / $50.26	Facility		$11.07	$33.33	$50.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $28.39 / $48.52	Professional		$11.11	$28.39	$48.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.36 / $44.36 / $163.03	Facility		$44.36	$44.36	$163.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $48.97 / $76.20	Professional		$34.29	$48.97	$76.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $15.87 / $24.16	Professional	26	$10.25	$15.87	$24.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $32.44 / $54.69	Professional	TC	$22.99	$32.44	$54.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.91 / $32.34 / $32.34	Professional		$16.91	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.61 / $57.93	Professional		$30.90	$38.61	$57.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $12.08 / $17.32	Professional	26	$9.59	$12.08	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.24 / $26.34 / $38.58	Professional	TC	$21.24	$26.34	$38.58