Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.57 / $172.80 / $417.99	Facility		$25.57	$172.80	$417.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $8.69 / $14.87	Facility	26	$7.31	$8.69	$14.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.98 / $26.84 / $302.83	Facility	TC	$16.98	$26.84	$302.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $29.78 / $53.23	Professional		$24.30	$29.78	$53.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.42 / $36.36	Professional	26	$7.76	$9.42	$36.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $18.53 / $34.95	Professional	TC	$16.35	$18.53	$34.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.62 / $31.28 / $36.79	Professional		$19.62	$31.28	$36.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $9.73 / $10.11	Professional	26	$6.19	$9.73	$10.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $16.75 / $16.75	Professional	TC	$16.75	$16.75	$16.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.67 / $28.82 / $52.33	Professional		$23.67	$28.82	$52.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $9.81 / $14.91	Professional	26	$8.09	$9.81	$14.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.93 / $17.53 / $36.83	Professional	TC	$15.93	$17.53	$36.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.59 / $22.61 / $35.57	Facility		$8.59	$22.61	$35.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.60 / $19.26 / $34.34	Professional		$8.60	$19.26	$34.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.32 / $31.32 / $197.24	Facility		$31.32	$31.32	$197.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.81 / $40.78 / $59.05	Professional		$24.81	$40.78	$59.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.38 / $19.26	Professional	26	$8.27	$12.38	$19.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.03 / $28.04 / $40.15	Professional	TC	$17.03	$28.04	$40.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $32.34 / $32.34	Professional		$14.70	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $23.79 / $28.38 / $40.42	Professional		$23.79	$28.38	$40.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.40 / $13.53	Professional	26	$7.56	$9.40	$13.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.88 / $19.85 / $28.93	Professional	TC	$15.88	$19.85	$28.93