Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $251.19 / $512.86	Facility		$33.88	$251.19	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.00 / $14.45	Facility	26	$7.41	$10.00	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $30.20 / $128.82	Facility	TC	$20.89	$30.20	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $33.11 / $75.86	Professional		$11.22	$33.11	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $38.02	Professional	26	$7.08	$10.96	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.12 / $46.77	Professional	TC	$18.62	$25.12	$46.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.12 / $36.31	Professional		$19.05	$25.12	$36.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.51 / $14.79	Professional	26	$5.75	$8.51	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $22.91 / $37.15	Professional	TC	$19.50	$22.91	$37.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $29.51 / $54.95	Professional		$28.18	$29.51	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.33 / $16.60	Professional	26	$9.12	$9.33	$16.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $19.50 / $37.15	Professional	TC	$18.62	$19.50	$37.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.94 / $28.18 / $41.69	Facility		$7.94	$28.18	$41.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.91 / $37.15	Professional		$7.94	$22.91	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $45.71 / $50.12	Facility		$23.44	$45.71	$50.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $151.36	Professional		$27.54	$50.12	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $41.69	Professional	26	$7.94	$14.13	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $35.48 / $114.82	Professional	TC	$19.50	$35.48	$114.82
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 $25.70 / $30.90 / $47.86	Professional		$25.70	$30.90	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $13.80	Professional	26	$7.59	$9.12	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.88 / $33.88	Professional	TC	$17.78	$21.88	$33.88