Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $239.88 / $457.09	Facility		$42.66	$239.88	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $9.55 / $13.49	Facility	26	$7.08	$9.55	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $28.84 / $67.61	Facility	TC	$19.05	$28.84	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $30.20 / $70.79	Professional		$11.22	$30.20	$70.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $39.81	Professional	26	$7.08	$14.13	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $141.25 / $281.84	Professional	50	$33.11	$141.25	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $27.54 / $46.77	Professional	TC	$16.98	$27.54	$46.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $22.39 / $51.29	Professional		$17.78	$22.39	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $6.46 / $11.22	Professional	26	$5.62	$6.46	$11.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $20.42 / $32.36	Professional	TC	$14.79	$20.42	$32.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $199.53 / $354.81	Facility		$28.18	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.18 / $47.86	Professional		$25.70	$28.18	$47.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.47 / $16.22	Professional	26	$8.32	$10.47	$16.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $42.66 / $72.44	Professional	50	$38.02	$42.66	$72.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.78 / $33.88	Professional	TC	$17.38	$17.78	$33.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $25.12 / $37.15	Facility		$8.91	$25.12	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $23.99 / $36.31	Professional		$8.13	$23.99	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $199.53 / $199.53	Facility		$47.86	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $40.74 / $58.88	Professional		$21.38	$40.74	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $17.38	Professional	26	$6.61	$10.47	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $46.77	Professional	TC	$17.38	$25.70	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $74.13 / $75.86	Facility		$20.89	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $29.51 / $46.77	Professional		$23.99	$29.51	$46.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.71 / $14.13	Professional	26	$7.24	$8.71	$14.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $20.42 / $33.88	Professional	TC	$16.98	$20.42	$33.88