Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.53 / $290.02 / $712.54	Facility		$31.53	$290.02	$712.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.89 / $8.83 / $16.03	Facility	26	$7.89	$8.83	$16.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.23 / $43.35 / $571.91	Facility	TC	$22.23	$43.35	$571.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.71 / $39.29 / $128.13	Professional		$18.71	$39.29	$128.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $10.60 / $40.99	Professional	26	$8.56	$10.60	$40.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $90.30 / $109.94	Professional	50	$19.27	$90.30	$109.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $23.69 / $79.56	Professional	TC	$20.50	$23.69	$79.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $37.79 / $45.36	Professional		$24.95	$37.79	$45.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $9.81 / $10.91	Professional	26	$6.69	$9.81	$10.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $49.51 / $49.51 / $49.51	Professional	50	$49.51	$49.51	$49.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $26.00 / $28.41	Professional	TC	$21.85	$26.00	$28.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $31.48 / $51.90	Professional		$24.88	$31.48	$51.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $9.88 / $15.63	Professional	26	$8.39	$9.88	$15.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.32 / $47.22 / $77.84	Professional	50	$37.32	$47.22	$77.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.04 / $19.57 / $35.84	Professional	TC	$16.04	$19.57	$35.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.27 / $29.50 / $43.85	Facility		$9.27	$29.50	$43.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $25.13 / $42.34	Professional		$9.36	$25.13	$42.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.14 / $39.14 / $163.03	Facility		$39.14	$39.14	$163.03
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 $29.23 / $42.19 / $66.55	Professional		$29.23	$42.19	$66.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.35 / $20.10	Professional	26	$8.71	$13.35	$20.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $29.68 / $46.01	Professional	TC	$19.64	$29.68	$46.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $32.34 / $32.34	Professional		$16.07	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.84 / $32.46 / $49.63	Professional		$25.84	$32.46	$49.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $10.16 / $16.57	Professional	26	$8.08	$10.16	$16.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.82 / $33.34	Professional	TC	$18.62	$23.82	$33.34