Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.75 / $228.34 / $423.05	Facility		$33.75	$228.34	$423.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.42 / $8.47 / $10.51	Facility	26	$7.42	$8.47	$10.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.82 / $24.26 / $361.02	Facility	TC	$18.82	$24.26	$361.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.02 / $27.35 / $48.82	Professional		$15.02	$27.35	$48.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $7.74 / $17.10	Professional	26	$6.74	$7.74	$17.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.04 / $20.44 / $32.54	Professional	TC	$17.04	$20.44	$32.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.09 / $23.13 / $31.64	Professional		$21.09	$23.13	$31.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $8.31 / $11.13	Professional	26	$5.90	$8.31	$11.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $28.43 / $29.30	Professional	TC	$28.43	$28.43	$29.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.15 / $187.82 / $200.00	Facility		$28.15	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.90 / $27.87 / $44.31	Professional		$24.90	$27.87	$44.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $10.00 / $14.20	Professional	26	$7.90	$10.00	$14.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.35 / $41.80 / $66.45	Professional	50	$37.35	$41.80	$66.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $17.87 / $29.10	Professional	TC	$16.89	$17.87	$29.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.16 / $22.74 / $35.60	Facility		$8.16	$22.74	$35.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.79 / $22.68 / $34.28	Professional		$7.79	$22.68	$34.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $200.00 / $200.00	Facility		$32.79	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $36.29 / $60.48	Professional		$25.65	$36.29	$60.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $10.23 / $17.11	Professional	26	$7.16	$10.23	$17.11
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.11 / $35.11 / $39.76	Professional	50	$35.11	$35.11	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $25.45 / $42.30	Professional	TC	$17.87	$25.45	$42.30
United Facility/Professional Facility Modifier Low / Median / High Price $10.34 / $33.20 / $194.81	Facility		$10.34	$33.20	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $24.54 / $28.92 / $53.39	Professional		$24.54	$28.92	$53.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $8.68 / $14.90	Professional	26	$7.22	$8.68	$14.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $21.74 / $35.36	Professional	TC	$17.14	$21.74	$35.36