Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $169.82 / $549.54	Facility		$27.54	$169.82	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $8.91 / $14.13	Facility	26	$7.41	$8.91	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $28.84 / $251.19	Facility	TC	$19.05	$28.84	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $89.13	Professional		$10.72	$32.36	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $39.81	Professional	26	$7.08	$11.75	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.49 / $89.13 / $141.25	Professional	50	$15.49	$89.13	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $44.67	Professional	TC	$16.98	$25.12	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $23.99 / $52.48	Professional		$18.20	$23.99	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.13 / $14.13	Professional	26	$5.75	$8.13	$14.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $20.42 / $32.36	Professional	TC	$15.49	$20.42	$32.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.18 / $50.12	Professional		$25.70	$28.18	$50.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.71 / $15.14	Professional	26	$8.32	$8.71	$15.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $39.81 / $74.13	Professional	50	$38.02	$39.81	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.78 / $33.11	Professional	TC	$17.38	$17.78	$33.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.94 / $25.12 / $38.02	Facility		$7.94	$25.12	$38.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $20.89 / $34.67	Professional		$7.94	$20.89	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $45.71 / $45.71	Facility		$20.89	$45.71	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.88	Facility	TC	$5.01	$23.44	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $40.74 / $138.04	Professional		$22.39	$40.74	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.49 / $39.81	Professional	26	$7.59	$13.49	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $31.62 / $102.33	Professional	TC	$18.62	$31.62	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $32.36 / $33.11	Professional		$14.13	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $43.65	Professional		$23.44	$28.18	$43.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.71 / $13.18	Professional	26	$7.24	$8.71	$13.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $19.50 / $29.51	Professional	TC	$16.22	$19.50	$29.51