Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $288.40 / $588.84	Facility		$64.57	$288.40	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $11.22 / $14.79	Facility	26	$8.32	$11.22	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $36.31 / $602.56	Facility	TC	$22.91	$36.31	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $38.02 / $104.71	Professional		$9.12	$38.02	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.45 / $45.71	Professional	26	$7.94	$14.45	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $95.50 / $165.96	Professional	50	$30.90	$95.50	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $37.15 / $75.86	Professional	TC	$20.89	$37.15	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $45.71	Professional		$21.88	$27.54	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.76 / $14.13	Professional	26	$6.61	$7.76	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $46.77 / $72.44	Professional	50	$38.90	$46.77	$72.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.55 / $40.74	Professional	TC	$16.60	$24.55	$40.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $199.53 / $354.81	Facility		$31.62	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $77.62	Professional		$28.18	$45.71	$77.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $18.62	Professional	26	$9.12	$12.02	$18.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $69.18 / $117.49	Professional	50	$42.66	$69.18	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $29.51 / $60.26	Professional	TC	$18.62	$29.51	$60.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $29.51 / $43.65	Facility		$10.47	$29.51	$43.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $28.18 / $42.66	Professional		$9.55	$28.18	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $199.53 / $199.53	Facility		$57.54	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $41.69 / $72.44	Professional		$13.80	$41.69	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $20.42	Professional	26	$7.94	$12.02	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.84 / $54.95	Professional	TC	$19.50	$28.84	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $74.13 / $75.86	Facility		$22.91	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.88 / $53.70	Professional		$26.92	$33.88	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $16.60	Professional	26	$8.32	$10.00	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $38.02	Professional	TC	$18.20	$22.91	$38.02