Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.39 / $57.62 / $391.20	Facility		$30.39	$57.62	$391.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.01 / $8.17 / $14.25	Facility	26	$7.01	$8.17	$14.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.77 / $23.07 / $131.72	Facility	TC	$20.77	$23.07	$131.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $34.10 / $120.02	Professional		$27.73	$34.10	$120.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $8.64 / $38.09	Professional	26	$7.43	$8.64	$38.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.88 / $92.36 / $106.00	Professional	50	$52.88	$92.36	$106.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.89 / $15.43 / $19.25	Professional	52	$13.89	$15.43	$19.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $23.69 / $44.36	Professional	TC	$20.07	$23.69	$44.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.09 / $32.54 / $43.97	Professional		$25.09	$32.54	$43.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $8.75 / $9.33	Professional	26	$5.94	$8.75	$9.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $61.66 / $61.66	Professional	50	$61.66	$61.66	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.21 / $26.98 / $45.16	Professional		$24.21	$26.98	$45.16
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 $36.32 / $40.47 / $67.73	Professional	50	$36.32	$40.47	$67.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.55 / $18.39 / $31.59	Professional	TC	$16.55	$18.39	$31.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.24 / $29.31 / $42.50	Facility		$8.24	$29.31	$42.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.58 / $25.13 / $41.03	Professional		$8.58	$25.13	$41.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $163.03	Facility		$38.02	$38.02	$163.03
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 / $40.22 / $64.54	Professional		$27.65	$40.22	$64.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $12.33 / $17.71	Professional	26	$7.67	$12.33	$17.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.67 / $29.59 / $48.41	Professional	TC	$19.67	$29.59	$48.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.87 / $32.34 / $32.34	Professional		$13.87	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $24.34 / $32.71 / $46.48	Professional		$24.34	$32.71	$46.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $8.77 / $12.99	Professional	26	$6.93	$8.77	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.02 / $23.57 / $34.36	Professional	TC	$17.02	$23.57	$34.36