Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.71 / $249.98 / $494.71	Facility		$29.71	$249.98	$494.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $8.52 / $14.87	Facility	26	$7.31	$8.52	$14.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.71 / $34.00 / $277.22	Facility	TC	$20.71	$34.00	$277.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $36.42 / $134.10	Professional		$18.57	$36.42	$134.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $10.25 / $36.38	Professional	26	$7.74	$10.25	$36.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.24 / $97.02 / $106.24	Professional	50	$59.24	$97.02	$106.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $26.62 / $50.90	Professional	TC	$21.49	$26.62	$50.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.37 / $35.63 / $42.75	Professional		$24.37	$35.63	$42.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $8.56 / $10.11	Professional	26	$6.19	$8.56	$10.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $20.72 / $26.94	Professional	TC	$19.03	$20.72	$26.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $30.79 / $51.20	Professional		$26.17	$30.79	$51.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $9.42 / $14.91	Professional	26	$7.99	$9.42	$14.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.25 / $46.18 / $76.80	Professional	50	$39.25	$46.18	$76.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $21.36 / $35.69	Professional	TC	$18.16	$21.36	$35.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.59 / $27.97 / $41.33	Facility		$8.59	$27.97	$41.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $23.83 / $39.90	Professional		$8.90	$23.83	$39.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.90 / $36.90 / $163.03	Facility		$36.90	$36.90	$163.03
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 $29.62 / $41.97 / $64.53	Professional		$29.62	$41.97	$64.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.38 / $19.26	Professional	26	$8.27	$12.38	$19.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $30.44 / $48.15	Professional	TC	$21.61	$30.44	$48.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $32.34 / $32.34	Professional		$16.07	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $32.54 / $44.51	Professional		$25.93	$32.54	$44.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $9.08 / $13.53	Professional	26	$7.57	$9.08	$13.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $23.60 / $33.57	Professional	TC	$18.57	$23.60	$33.57