Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.08 / $266.49 / $498.16	Facility		$74.08	$266.49	$498.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $8.84 / $13.08	Facility	26	$7.75	$8.84	$13.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.90 / $37.61 / $349.11	Facility	TC	$28.90	$37.61	$349.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.77 / $36.88 / $76.59	Professional		$12.77	$36.88	$76.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $8.69 / $22.82	Professional	26	$7.63	$8.69	$22.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $106.16 / $148.94 / $154.00	Professional	50	$106.16	$148.94	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $30.11 / $61.00	Professional	TC	$25.37	$30.11	$61.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $35.64 / $55.70	Professional		$29.70	$35.64	$55.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $7.74 / $11.61	Professional	26	$6.19	$7.74	$11.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $59.26 / $89.11 / $89.11	Professional	50	$59.26	$89.11	$89.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.07 / $45.28 / $66.11	Professional	TC	$44.07	$45.28	$66.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.41 / $187.82 / $200.00	Facility		$31.41	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $42.22 / $69.23	Professional		$28.27	$42.22	$69.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.73	Professional	26	$9.11	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.40 / $63.33 / $103.86	Professional	50	$42.40	$63.33	$103.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $27.51 / $53.88	Professional	TC	$19.80	$27.51	$53.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.30 / $35.26 / $50.13	Facility		$8.30	$35.26	$50.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $33.79 / $48.27	Professional		$8.13	$33.79	$48.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $200.00 / $200.00	Facility		$46.23	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $36.90 / $36.90 / $36.90	Facility	TC	$36.90	$36.90	$36.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.21 / $42.05 / $83.18	Professional		$30.21	$42.05	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.91 / $11.06 / $18.73	Professional	26	$7.91	$11.06	$18.73
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.36 / $47.36 / $53.88	Professional	50	$47.36	$47.36	$53.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.43 / $30.80 / $65.31	Professional	TC	$22.43	$30.80	$65.31
United Facility/Professional Professional Modifier Low / Median / High Price $30.62 / $38.61 / $67.61	Professional		$30.62	$38.61	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $9.10 / $15.56	Professional	26	$7.85	$9.10	$15.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $28.95 / $51.54	Professional	TC	$22.28	$28.95	$51.54