Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $208.93 / $489.78	Facility		$32.36	$208.93	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $9.77 / $14.79	Facility	26	$8.13	$9.77	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $33.88 / $251.19	Facility	TC	$21.38	$33.88	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $36.31 / $93.33	Professional		$11.22	$36.31	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.02 / $37.15	Professional	26	$7.41	$12.02	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $97.72 / $162.18	Professional	50	$42.66	$97.72	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $54.95	Professional	TC	$19.05	$29.51	$54.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.18 / $58.88	Professional		$20.89	$28.18	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.51 / $15.85	Professional	26	$6.31	$8.51	$15.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $36.31 / $45.71	Professional	50	$30.20	$36.31	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.92 / $42.66	Professional	TC	$18.20	$26.92	$42.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $32.36 / $57.54	Professional		$30.20	$32.36	$57.54
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 50 Low / Median / High Price $44.67 / $46.77 / $87.10	Professional	50	$44.67	$46.77	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $21.38 / $39.81	Professional	TC	$20.89	$21.38	$39.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $28.18 / $42.66	Facility		$8.51	$28.18	$42.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $22.91 / $38.02	Professional		$8.51	$22.91	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $44.67 / $54.95	Facility		$23.44	$44.67	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
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 $28.84 / $52.48 / $151.36	Professional		$28.84	$52.48	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.45 / $41.69	Professional	26	$8.32	$14.45	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $114.82	Professional	TC	$20.89	$38.90	$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 $26.30 / $32.36 / $51.29	Professional		$26.30	$32.36	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.12 / $14.45	Professional	26	$7.76	$9.12	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.44 / $35.48	Professional	TC	$18.62	$23.44	$35.48