Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.41 / $275.13 / $570.38	Facility		$66.41	$275.13	$570.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.38 / $10.05 / $426.57	Facility	26	$8.38	$10.05	$426.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.68 / $33.13 / $474.00	Facility	TC	$22.68	$33.13	$474.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.14 / $31.06 / $64.95	Professional		$9.14	$31.06	$64.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $8.93 / $21.86	Professional	26	$8.15	$8.93	$21.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.86 / $107.78 / $130.00	Professional	50	$17.86	$107.78	$130.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.69 / $48.00	Professional	TC	$19.14	$23.69	$48.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $29.94 / $46.79	Professional		$24.95	$29.94	$46.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $8.36 / $12.56	Professional	26	$6.69	$8.36	$12.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $40.90 / $74.86 / $74.86	Professional	50	$40.90	$74.86	$74.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.16 / $34.22 / $35.22	Professional	TC	$27.16	$34.22	$35.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.48 / $187.82 / $200.00	Facility		$31.48	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $42.40 / $69.91	Professional		$28.42	$42.40	$69.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $11.90 / $16.80	Professional	26	$9.52	$11.90	$16.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.63 / $63.61 / $104.87	Professional	50	$42.63	$63.61	$104.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $27.02 / $53.88	Professional	TC	$18.82	$27.02	$53.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.94 / $27.38 / $42.11	Facility		$8.94	$27.38	$42.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.78 / $27.09 / $40.54	Professional		$8.78	$27.09	$40.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.14 / $200.00 / $200.00	Facility		$39.14	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.34 / $40.65 / $70.40	Professional		$29.34	$40.65	$70.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.91 / $19.43	Professional	26	$8.51	$11.91	$19.43
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $44.46	Professional	50	$39.20	$39.20	$44.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $27.01 / $51.10	Professional	TC	$19.57	$27.01	$51.10
United Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $33.57 / $57.05	Professional		$27.11	$33.57	$57.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.21 / $17.04	Professional	26	$8.51	$10.21	$17.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.92 / $23.82 / $42.88	Professional	TC	$18.92	$23.82	$42.88