Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.34 / $233.19 / $454.05	Facility		$55.34	$233.19	$454.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.13 / $8.52 / $12.03	Facility	26	$7.13	$8.52	$12.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.12 / $24.63 / $277.87	Facility	TC	$19.12	$24.63	$277.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.25 / $27.35 / $51.51	Professional		$13.25	$27.35	$51.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.86 / $7.49 / $17.94	Professional	26	$6.86	$7.49	$17.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.35 / $20.64 / $38.84	Professional	TC	$17.35	$20.64	$38.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.37 / $22.41 / $25.31	Professional		$21.37	$22.41	$25.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $6.84 / $10.19	Professional	26	$5.70	$6.84	$10.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.37 / $187.82 / $200.00	Facility		$28.37	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $28.37 / $45.10	Professional		$25.38	$28.37	$45.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.50 / $14.64	Professional	26	$8.34	$10.50	$14.64
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.07 / $42.55 / $67.66	Professional	50	$38.07	$42.55	$67.66
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 $7.83 / $23.09 / $35.60	Facility		$7.83	$23.09	$35.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $23.03 / $34.28	Professional		$7.48	$23.03	$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 $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.90 / $36.10 / $59.42	Professional		$25.90	$36.10	$59.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.21 / $16.72	Professional	26	$7.25	$10.21	$16.72
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.49 / $36.49 / $41.33	Professional	50	$36.49	$36.49	$41.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $25.35 / $43.90	Professional	TC	$17.96	$25.35	$43.90
United Facility/Professional Facility Modifier Low / Median / High Price $194.81 / $194.81 / $194.81	Facility		$194.81	$194.81	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $29.45 / $51.90	Professional		$24.26	$29.45	$51.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $8.88 / $14.53	Professional	26	$7.37	$8.88	$14.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $20.57 / $34.97	Professional	TC	$16.98	$20.57	$34.97