Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.27 / $301.19 / $517.75	Facility		$38.27	$301.19	$517.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.36 / $10.93 / $19.03	Facility	26	$9.36	$10.93	$19.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.42 / $48.91 / $424.87	Facility	TC	$25.42	$48.91	$424.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.76 / $44.36 / $158.81	Professional		$35.76	$44.36	$158.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $14.04 / $44.00	Professional	26	$10.02	$14.04	$44.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.25 / $30.16 / $57.71	Professional	TC	$25.25	$30.16	$57.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $43.33 / $51.99	Professional		$30.40	$43.33	$51.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $9.56 / $12.95	Professional	26	$7.97	$9.56	$12.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $24.69 / $32.10	Professional	TC	$20.99	$24.69	$32.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.31 / $37.50 / $57.84	Professional		$30.31	$37.50	$57.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $11.88 / $19.05	Professional	26	$9.88	$11.88	$19.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.43 / $24.05 / $37.97	Professional	TC	$20.43	$24.05	$37.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.01 / $33.33 / $50.26	Facility		$11.01	$33.33	$50.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.45 / $28.39 / $48.52	Professional		$11.45	$28.39	$48.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.74 / $44.74 / $197.24	Facility		$44.74	$44.74	$197.24
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 $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $51.50 / $76.20	Professional		$34.29	$51.50	$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 $24.81 / $34.29 / $54.69	Professional	TC	$24.81	$34.29	$54.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.86 / $32.34 / $32.34	Professional		$18.86	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $38.61 / $54.07	Professional		$32.11	$38.61	$54.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $11.72 / $17.05	Professional	26	$9.32	$11.72	$17.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $27.07 / $40.60	Professional	TC	$22.46	$27.07	$40.60