Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $269.15 / $602.56	Facility		$35.48	$269.15	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.47 / $16.60	Facility	26	$8.71	$10.47	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $39.81 / $575.44	Facility	TC	$22.91	$39.81	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $40.74 / $97.72	Professional		$11.75	$40.74	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.88 / $43.65	Professional	26	$8.32	$12.88	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $27.54 / $70.79 / $131.83	Professional	50	$27.54	$70.79	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $79.43	Professional	TC	$19.95	$32.36	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $54.95	Professional		$21.88	$28.84	$54.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $9.33 / $16.60	Professional	26	$6.76	$9.33	$16.60
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $44.67 / $70.79	Professional	50	$32.36	$44.67	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $42.66	Professional	TC	$17.78	$25.70	$42.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $31.62 / $54.95	Professional		$28.18	$31.62	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.23 / $17.38	Professional	26	$9.55	$10.23	$17.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $47.86 / $81.28	Professional	50	$42.66	$47.86	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $19.50 / $38.90	Professional	TC	$18.62	$19.50	$38.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $29.51 / $45.71	Facility		$9.33	$29.51	$45.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $23.99 / $40.74	Professional		$9.33	$23.99	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $53.70 / $53.70	Facility		$25.12	$53.70	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $43.65 / $162.18	Professional		$22.39	$43.65	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $15.49 / $43.65	Professional	26	$8.71	$15.49	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $35.48 / $120.23	Professional	TC	$19.50	$35.48	$120.23
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 $26.92 / $31.62 / $50.12	Professional		$26.92	$31.62	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.77 / $15.49	Professional	26	$8.32	$9.77	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.88 / $33.88	Professional	TC	$17.78	$21.88	$33.88