Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.64 / $200.00 / $325.85	Facility		$33.64	$200.00	$325.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.42 / $7.43 / $9.50	Facility	26	$7.42	$7.43	$9.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.60 / $24.72 / $69.89	Facility	TC	$20.60	$24.72	$69.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $28.04 / $45.32	Professional		$16.80	$28.04	$45.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $7.72 / $15.02	Professional	26	$7.01	$7.72	$15.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $120.00 / $120.00	Professional	50	$47.52	$120.00	$120.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.60 / $14.02 / $17.77	Professional	52	$10.60	$14.02	$17.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.22 / $20.60 / $29.02	Professional	TC	$17.22	$20.60	$29.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $28.16 / $34.15	Professional		$23.39	$28.16	$34.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $8.56 / $11.88	Professional	26	$5.82	$8.56	$11.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.03 / $37.03 / $37.03	Professional	50	$37.03	$37.03	$37.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $32.04 / $32.04	Professional	TC	$32.04	$32.04	$32.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.09 / $200.00 / $263.76	Facility		$28.09	$200.00	$263.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $28.09 / $44.94	Professional		$24.75	$28.09	$44.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.90 / $15.04	Professional	26	$8.34	$10.90	$15.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.11 / $42.13 / $67.41	Professional	50	$37.11	$42.13	$67.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $17.19 / $27.50	Professional	TC	$16.26	$17.19	$27.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.95 / $24.89 / $38.02	Facility		$7.95	$24.89	$38.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.79 / $24.80 / $36.61	Professional		$7.79	$24.80	$36.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $200.00 / $200.00	Facility		$35.40	$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 $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.50 / $36.60 / $63.47	Professional		$26.50	$36.60	$63.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.46 / $17.11	Professional	26	$7.25	$10.46	$17.11
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $42.89	Professional	50	$37.85	$37.85	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.25 / $26.44 / $46.36	Professional	TC	$18.25	$26.44	$46.36
United Facility/Professional Facility Modifier Low / Median / High Price $235.69 / $235.69 / $235.69	Facility		$235.69	$235.69	$235.69
United Facility/Professional Professional Modifier Low / Median / High Price $24.39 / $30.68 / $52.16	Professional		$24.39	$30.68	$52.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.88 / $14.90	Professional	26	$7.41	$8.88	$14.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.66 / $21.84 / $37.71	Professional	TC	$16.66	$21.84	$37.71