Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.62 / $200.00 / $488.50	Facility		$42.62	$200.00	$488.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.02 / $10.29 / $15.23	Facility	26	$9.02	$10.29	$15.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.60 / $32.28 / $329.92	Facility	TC	$20.60	$32.28	$329.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $34.11 / $61.00	Professional		$27.13	$34.11	$61.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $9.73 / $18.88	Professional	26	$8.50	$9.73	$18.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $22.33 / $35.61	Professional	TC	$18.64	$22.33	$35.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $25.98 / $29.92	Professional		$23.80	$25.98	$29.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $10.81 / $13.52	Professional	26	$7.21	$10.81	$13.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $31.11 / $32.04	Professional	TC	$22.06	$31.11	$32.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.59 / $200.00 / $263.76	Facility		$36.59	$200.00	$263.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $36.59 / $58.17	Professional		$32.10	$36.59	$58.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $14.60 / $20.14	Professional	26	$11.28	$14.60	$20.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $21.99 / $35.84	Professional	TC	$20.74	$21.99	$35.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.96 / $24.89 / $40.15	Facility		$9.96	$24.89	$40.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.46 / $24.84 / $38.68	Professional		$9.46	$24.84	$38.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.90 / $200.00 / $200.00	Facility		$36.90	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
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 $28.81 / $43.06 / $72.81	Professional		$28.81	$43.06	$72.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $13.12 / $23.00	Professional	26	$9.30	$13.12	$23.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.61 / $29.50 / $49.82	Professional	TC	$20.61	$29.50	$49.82
United Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $35.44 / $57.82	Professional		$28.91	$35.44	$57.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $11.46 / $18.85	Professional	26	$9.40	$11.46	$18.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $23.71 / $40.69	Professional	TC	$18.39	$23.71	$40.69