Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.49 / $200.00 / $402.62	Facility		$36.49	$200.00	$402.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.42 / $8.91 / $10.66	Facility	26	$7.42	$8.91	$10.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.97 / $28.57 / $79.19	Facility	TC	$22.97	$28.57	$79.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $31.49 / $60.46	Professional		$22.44	$31.49	$60.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $7.79 / $16.80	Professional	26	$7.01	$7.79	$16.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.20 / $92.36 / $126.00	Professional	50	$51.20	$92.36	$126.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.87 / $15.43 / $19.25	Professional	52	$12.87	$15.43	$19.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.22 / $22.97 / $36.85	Professional	TC	$19.22	$22.97	$36.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.47 / $26.49 / $45.36	Professional		$24.47	$26.49	$45.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $7.77 / $11.13	Professional	26	$5.90	$7.77	$11.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $32.86 / $32.86	Professional	TC	$32.86	$32.86	$32.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.43 / $187.82 / $200.00	Facility		$28.43	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.06 / $28.43 / $45.20	Professional		$25.06	$28.43	$45.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.90 / $15.38	Professional	26	$8.34	$10.90	$15.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.59 / $42.64 / $67.20	Professional	50	$37.59	$42.64	$67.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $17.53 / $28.04	Professional	TC	$16.57	$17.53	$28.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.89 / $27.38 / $40.82	Facility		$7.89	$27.38	$40.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.79 / $26.24 / $39.31	Professional		$7.79	$26.24	$39.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $200.00 / $200.00	Facility		$38.02	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.65 / $39.08 / $68.89	Professional		$27.65	$39.08	$68.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $10.64 / $17.27	Professional	26	$7.54	$10.64	$17.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $47.09	Professional	50	$41.47	$41.47	$47.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $27.01 / $51.78	Professional	TC	$19.19	$27.01	$51.78
United Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $32.95 / $56.44	Professional		$26.36	$32.95	$56.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $9.16 / $15.11	Professional	26	$7.36	$9.16	$15.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.01 / $24.51 / $41.72	Professional	TC	$18.01	$24.51	$41.72