Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $186.21 / $537.03	Facility		$30.20	$186.21	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $10.96 / $14.79	Facility	26	$8.13	$10.96	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $32.36 / $41.69	Facility	TC	$20.89	$32.36	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $43.65 / $114.82	Professional		$25.70	$43.65	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $29.51	Professional	26	$7.08	$10.96	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $47.86	Professional	TC	$19.05	$25.70	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $23.44 / $36.31	Professional		$20.42	$23.44	$36.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.51 / $16.60	Professional	26	$6.31	$8.51	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $22.39 / $42.66	Professional	TC	$17.38	$22.39	$42.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $30.20 / $54.95	Professional		$28.18	$30.20	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.33 / $16.60	Professional	26	$9.12	$9.33	$16.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $19.50 / $37.15	Professional	TC	$19.05	$19.50	$37.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $28.18 / $42.66	Facility		$8.51	$28.18	$42.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $22.91 / $38.02	Professional		$8.51	$22.91	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $51.29 / $51.29	Facility		$23.44	$51.29	$51.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $151.36	Professional		$28.18	$45.71	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.45 / $41.69	Professional	26	$8.32	$14.45	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $35.48 / $114.82	Professional	TC	$19.95	$35.48	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $33.11	Professional		$15.49	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.90 / $47.86	Professional		$25.70	$30.90	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.12 / $14.45	Professional	26	$7.76	$9.12	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.88 / $32.36	Professional	TC	$17.78	$21.88	$32.36