Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $302.00 / $602.56	Facility		$45.71	$302.00	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $9.77 / $15.14	Facility	26	$8.13	$9.77	$15.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $46.77 / $575.44	Facility	TC	$28.84	$46.77	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $46.77 / $131.83	Professional		$11.48	$46.77	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.80 / $42.66	Professional	26	$7.76	$13.80	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $128.82 / $194.98	Professional	50	$44.67	$128.82	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.90 / $69.18	Professional	TC	$25.12	$38.90	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $66.07	Professional		$26.30	$33.88	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.12 / $15.49	Professional	26	$6.31	$9.12	$15.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $58.88 / $77.62	Professional	50	$44.67	$58.88	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $53.70	Professional	TC	$21.38	$33.11	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $54.95	Professional		$28.84	$33.11	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.77 / $16.60	Professional	26	$9.12	$9.77	$16.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $48.98 / $81.28	Professional	50	$42.66	$48.98	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.44 / $39.81	Professional	TC	$19.95	$23.44	$39.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $35.48 / $53.70	Facility		$8.51	$35.48	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $30.90 / $47.86	Professional		$8.51	$30.90	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $64.57 / $64.57	Facility		$32.36	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.76 / $35.48 / $51.29	Facility	TC	$7.76	$35.48	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $194.98	Professional		$29.51	$46.77	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.45 / $41.69	Professional	26	$8.32	$14.45	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $42.66 / $154.88	Professional	TC	$22.91	$42.66	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $32.36 / $33.11	Professional		$14.45	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $35.48 / $57.54	Professional		$27.54	$35.48	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $14.45	Professional	26	$7.76	$9.33	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $42.66	Professional	TC	$19.05	$26.30	$42.66