Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.02 / $339.58 / $692.52	Facility		$40.02	$339.58	$692.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $8.52 / $14.87	Facility	26	$7.31	$8.52	$14.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.09 / $55.00 / $571.91	Facility	TC	$26.09	$55.00	$571.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $44.56 / $175.00	Professional		$22.22	$44.56	$175.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.21 / $38.92	Professional	26	$7.76	$11.21	$38.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $113.54 / $299.48	Professional	50	$17.85	$113.54	$299.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $30.11 / $67.81	Professional	TC	$25.37	$30.11	$67.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $44.85 / $53.82	Professional		$30.70	$44.85	$53.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $8.44 / $10.11	Professional	26	$6.19	$8.44	$10.11
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $50.65 / $50.65 / $50.65	Professional	50	$50.65	$50.65	$50.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $32.96 / $36.53	Professional	TC	$28.10	$32.96	$36.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.81 / $32.74 / $51.40	Professional		$27.81	$32.74	$51.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $9.42 / $14.91	Professional	26	$7.99	$9.42	$14.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.71 / $49.11 / $77.09	Professional	50	$41.71	$49.11	$77.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $23.31 / $40.00	Professional	TC	$18.80	$23.31	$40.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.67 / $35.88 / $52.03	Facility		$8.67	$35.88	$52.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.60 / $32.32 / $50.23	Professional		$8.60	$32.32	$50.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $46.23 / $163.03	Facility		$46.23	$46.23	$163.03
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 $30.64 / $46.60 / $79.04	Professional		$30.64	$46.60	$79.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.24 / $19.73	Professional	26	$8.27	$12.24	$19.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.42 / $34.22 / $62.22	Professional	TC	$23.42	$34.22	$62.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $32.34 / $32.34	Professional		$14.98	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $27.33 / $36.51 / $54.08	Professional		$27.33	$36.51	$54.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.42 / $13.53	Professional	26	$7.56	$9.42	$13.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.51 / $28.68 / $45.48	Professional	TC	$19.51	$28.68	$45.48