Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.64 / $241.16 / $396.46	Facility		$49.64	$241.16	$396.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $8.08 / $11.56	Facility	26	$7.76	$8.08	$11.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.49 / $27.69 / $75.06	Facility	TC	$21.49	$27.69	$75.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.23 / $30.30 / $54.23	Professional		$25.23	$30.30	$54.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.31 / $8.02 / $17.53	Professional	26	$7.31	$8.02	$17.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $21.70 / $38.84	Professional	TC	$19.14	$21.70	$38.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $25.72 / $46.99	Professional		$23.50	$25.72	$46.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $8.21 / $11.91	Professional	26	$6.19	$8.21	$11.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.74 / $33.40 / $33.40	Professional	TC	$25.74	$33.40	$33.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.98 / $187.82 / $200.00	Facility		$30.98	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $30.98 / $49.25	Professional		$27.83	$30.98	$49.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.73	Professional	26	$9.11	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $19.57 / $32.29	Professional	TC	$18.82	$19.57	$32.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.30 / $25.96 / $39.65	Facility		$8.30	$25.96	$39.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $24.96 / $38.18	Professional		$8.13	$24.96	$38.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.53 / $200.00 / $200.00	Facility		$36.53	$200.00	$200.00
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 $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.19 / $39.58 / $67.41	Professional		$28.19	$39.58	$67.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.91 / $11.06 / $18.27	Professional	26	$7.91	$11.06	$18.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $28.15 / $48.39	Professional	TC	$19.72	$28.15	$48.39
United Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $31.76 / $56.49	Professional		$26.75	$31.76	$56.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $9.25 / $15.56	Professional	26	$7.85	$9.25	$15.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.41 / $22.74 / $38.54	Professional	TC	$18.41	$22.74	$38.54