Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.62 / $280.32 / $524.48	Facility		$50.62	$280.32	$524.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $8.84 / $13.08	Facility	26	$7.75	$8.84	$13.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.49 / $30.34 / $266.63	Facility	TC	$21.49	$30.34	$266.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.30 / $30.82 / $58.00	Professional		$14.30	$30.82	$58.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.13 / $17.94	Professional	26	$7.33	$8.13	$17.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $114.74 / $114.74 / $114.74	Professional	50	$114.74	$114.74	$114.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.44 / $23.51 / $46.00	Professional	TC	$19.44	$23.51	$46.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $29.37 / $44.06	Professional		$23.50	$29.37	$44.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.18 / $7.15 / $11.61	Professional	26	$6.18	$7.15	$11.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.48 / $70.48 / $70.48	Professional	50	$70.48	$70.48	$70.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $32.45 / $33.40	Professional	TC	$19.03	$32.45	$33.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $187.82 / $200.00	Facility		$33.54	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.37 / $32.70 / $51.99	Professional		$29.37	$32.70	$51.99
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 50 Low / Median / High Price $44.05 / $49.05 / $77.98	Professional	50	$44.05	$49.05	$77.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $21.30 / $34.08	Professional	TC	$20.42	$21.30	$34.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.23 / $25.96 / $39.65	Facility		$8.23	$25.96	$39.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $24.87 / $38.18	Professional		$8.13	$24.87	$38.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.90 / $200.00 / $200.00	Facility		$36.90	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.44 / $39.58 / $68.50	Professional		$29.44	$39.58	$68.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.91 / $11.06 / $18.23	Professional	26	$7.91	$11.06	$18.23
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.75 / $38.75 / $43.94	Professional	50	$38.75	$38.75	$43.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.55 / $28.21 / $48.39	Professional	TC	$21.55	$28.21	$48.39
United Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $32.88 / $56.52	Professional		$28.10	$32.88	$56.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $9.03 / $15.44	Professional	26	$7.67	$9.03	$15.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $24.21 / $40.44	Professional	TC	$20.14	$24.21	$40.44