Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.91 / $200.11 / $502.11	Facility		$26.91	$200.11	$502.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.01 / $7.87 / $14.25	Facility	26	$7.01	$7.87	$14.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.17 / $30.57 / $285.95	Facility	TC	$18.17	$30.57	$285.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.05 / $30.31 / $107.77	Professional		$24.05	$30.31	$107.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $9.30 / $34.32	Professional	26	$7.01	$9.30	$34.32
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $84.92 / $91.72 / $91.77	Professional	50	$84.92	$91.72	$91.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $21.35 / $36.82	Professional	TC	$18.17	$21.35	$36.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $32.67 / $38.43	Professional		$21.93	$32.67	$38.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $8.75 / $9.69	Professional	26	$5.94	$8.75	$9.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $18.17 / $18.17	Professional	TC	$18.17	$18.17	$18.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.96 / $25.83 / $44.81	Professional		$21.96	$25.83	$44.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.14 / $12.88	Professional	26	$6.92	$8.14	$12.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.94 / $38.74 / $67.20	Professional	50	$32.94	$38.74	$67.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.04 / $17.87 / $30.59	Professional	TC	$15.04	$17.87	$30.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.24 / $24.53 / $37.15	Facility		$8.24	$24.53	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.33 / $20.90 / $35.86	Professional		$8.33	$20.90	$35.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $32.79 / $163.03	Facility		$32.79	$32.79	$163.03
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 / $38.13 / $56.38	Professional		$25.65	$38.13	$56.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $11.35 / $16.87	Professional	26	$7.67	$11.35	$16.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $26.09 / $40.25	Professional	TC	$18.70	$26.09	$40.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $32.34 / $32.34	Professional		$14.70	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $38.54 / $38.54 / $38.54	Facility		$38.54	$38.54	$38.54
United Facility/Professional Professional Modifier Low / Median / High Price $22.89 / $28.33 / $43.31	Professional		$22.89	$28.33	$43.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.87 / $9.00 / $12.99	Professional	26	$6.87	$9.00	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $20.21 / $30.32	Professional	TC	$16.17	$20.21	$30.32