Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.32 / $219.62 / $510.16	Facility		$26.32	$219.62	$510.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.74 / $7.86 / $13.70	Facility	26	$6.74	$7.86	$13.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.44 / $26.66 / $253.57	Facility	TC	$18.44	$26.66	$253.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $31.18 / $112.68	Professional		$17.30	$31.18	$112.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.44 / $36.03	Professional	26	$7.03	$9.44	$36.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.30 / $88.30 / $88.30	Professional	50	$88.30	$88.30	$88.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $20.64 / $40.54	Professional	TC	$18.21	$20.64	$40.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.19 / $22.41 / $28.40	Professional		$19.19	$22.41	$28.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.89 / $9.32	Professional	26	$5.70	$7.89	$9.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.34 / $26.29 / $42.61	Professional		$22.34	$26.29	$42.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $8.59 / $13.58	Professional	26	$7.30	$8.59	$13.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.51 / $39.43 / $63.91	Professional	50	$33.51	$39.43	$63.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.04 / $17.87 / $29.10	Professional	TC	$15.04	$17.87	$29.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.92 / $24.91 / $37.15	Facility		$7.92	$24.91	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.19 / $21.22 / $35.86	Professional		$8.19	$21.22	$35.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $32.79 / $163.03	Facility		$32.79	$32.79	$163.03
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 / $38.13 / $56.38	Professional		$25.90	$38.13	$56.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $11.87 / $17.71	Professional	26	$7.58	$11.87	$17.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.02 / $40.88	Professional	TC	$18.62	$26.02	$40.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $32.34 / $32.34	Professional		$14.70	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $23.54 / $29.23 / $45.33	Professional		$23.54	$29.23	$45.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $8.66 / $12.99	Professional	26	$7.17	$8.66	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.36 / $18.79 / $28.80	Professional	TC	$16.36	$18.79	$28.80