Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.05 / $67.16 / $278.20	Facility		$28.05	$67.16	$278.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.01 / $7.87 / $14.25	Facility	26	$7.01	$7.87	$14.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.87 / $20.71 / $119.93	Facility	TC	$19.87	$20.71	$119.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $30.14 / $163.00	Professional		$24.92	$30.14	$163.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $7.87 / $35.74	Professional	26	$7.03	$7.87	$35.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $101.89 / $101.89	Professional	50	$47.52	$101.89	$101.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.83 / $14.61 / $87.13	Professional	52	$12.83	$14.61	$87.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $21.57 / $42.62	Professional	TC	$18.64	$21.57	$42.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $34.15 / $41.00	Professional		$23.39	$34.15	$41.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.33 / $14.55	Professional	26	$5.94	$9.33	$14.55
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.08 / $35.08 / $35.08	Professional	50	$35.08	$35.08	$35.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.75 / $38.75 / $38.75	Professional	TC	$25.75	$38.75	$38.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $27.19 / $43.18	Professional		$21.77	$27.19	$43.18
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 $32.65 / $40.36 / $64.78	Professional	50	$32.65	$40.36	$64.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.47 / $17.03 / $28.76	Professional	TC	$14.47	$17.03	$28.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.24 / $26.82 / $39.63	Facility		$8.24	$26.82	$39.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.52 / $22.85 / $38.26	Professional		$8.52	$22.85	$38.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $197.24	Facility		$35.40	$35.40	$197.24
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 $26.06 / $38.22 / $60.15	Professional		$26.06	$38.22	$60.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $11.87 / $17.71	Professional	26	$7.67	$11.87	$17.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $27.06 / $43.13	Professional	TC	$18.32	$27.06	$43.13
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 $23.23 / $29.34 / $46.02	Professional		$23.23	$29.34	$46.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $9.02 / $12.99	Professional	26	$7.19	$9.02	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.53 / $20.92 / $31.69	Professional	TC	$16.53	$20.92	$31.69