Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $231.37 / $393.24	Facility		$41.38	$231.37	$393.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.42 / $8.47 / $14.33	Facility	26	$7.42	$8.47	$14.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.49 / $27.69 / $75.06	Facility	TC	$21.49	$27.69	$75.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $29.48 / $53.70	Professional		$14.00	$29.48	$53.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $7.99 / $15.33	Professional	26	$7.12	$7.99	$15.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $21.59 / $34.47	Professional	TC	$18.82	$21.59	$34.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $24.44 / $25.20	Professional		$23.87	$24.44	$25.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.45 / $10.68	Professional	26	$5.70	$7.45	$10.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.40 / $33.40 / $33.40	Professional	TC	$33.40	$33.40	$33.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.98 / $187.82 / $200.00	Facility		$30.98	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $30.98 / $49.25	Professional		$27.83	$30.98	$49.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.73	Professional	26	$9.11	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $19.57 / $32.29	Professional	TC	$18.82	$19.57	$32.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.64 / $25.96 / $38.81	Facility		$7.64	$25.96	$38.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $24.87 / $37.38	Professional		$7.48	$24.87	$37.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.79 / $200.00 / $200.00	Facility		$35.79	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $38.79 / $65.98	Professional		$28.16	$38.79	$65.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.64 / $18.73	Professional	26	$7.38	$10.64	$18.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $26.93 / $48.39	Professional	TC	$19.48	$26.93	$48.39
United Facility/Professional Professional Modifier Low / Median / High Price $26.41 / $31.76 / $56.43	Professional		$26.41	$31.76	$56.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.17 / $15.11	Professional	26	$7.79	$9.17	$15.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.63 / $23.10 / $40.50	Professional	TC	$18.63	$23.10	$40.50