Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $257.04 / $616.60	Facility		$30.90	$257.04	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $11.22 / $17.78	Facility	26	$9.33	$11.22	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $35.48 / $446.68	Facility	TC	$20.89	$35.48	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $141.25	Professional		$26.92	$40.74	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.45 / $46.77	Professional	26	$8.51	$14.45	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $47.86	Professional	TC	$18.20	$25.70	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $24.55 / $52.48	Professional		$20.42	$24.55	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.47 / $17.78	Professional	26	$7.41	$10.47	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.38 / $38.02	Professional	TC	$15.49	$21.38	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $34.67 / $63.10	Professional		$32.36	$34.67	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.75 / $20.89	Professional	26	$11.22	$11.75	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $21.88 / $41.69	Professional	TC	$20.89	$21.88	$41.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $26.92 / $43.65	Facility		$10.00	$26.92	$43.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $21.88 / $38.90	Professional		$10.00	$21.88	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $51.29 / $51.29	Facility		$22.39	$51.29	$51.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.34 / $10.96 / $15.85	Facility	26	$2.34	$10.96	$15.85
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $47.86 / $158.49	Professional		$22.91	$47.86	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $18.20 / $53.70	Professional	26	$9.77	$18.20	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $38.02 / $109.65	Professional	TC	$20.42	$38.02	$109.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $32.36 / $33.11	Professional		$17.78	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $51.29	Professional		$28.18	$34.67	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.48 / $17.38	Professional	26	$9.33	$11.48	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $34.67	Professional	TC	$18.20	$22.91	$34.67