Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $263.03 / $501.19	Facility		$74.13	$263.03	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $10.47 / $14.45	Facility	26	$7.76	$10.47	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $38.02 / $363.08	Facility	TC	$25.12	$38.02	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $41.69 / $117.49	Professional		$8.71	$41.69	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $15.49 / $46.77	Professional	26	$7.59	$15.49	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.12 / $104.71 / $194.98	Professional	50	$25.12	$104.71	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $83.18	Professional	TC	$22.91	$41.69	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.20 / $48.98	Professional		$23.44	$30.20	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.41 / $13.18	Professional	26	$6.17	$7.41	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $47.86 / $75.86	Professional	50	$37.15	$47.86	$75.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $47.86	Professional	TC	$19.05	$28.84	$47.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $199.53 / $354.81	Facility		$30.20	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $42.66 / $75.86	Professional		$27.54	$42.66	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.48 / $17.78	Professional	26	$8.71	$11.48	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $64.57 / $112.20	Professional	50	$41.69	$64.57	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $58.88	Professional	TC	$18.62	$28.18	$58.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $32.36 / $46.77	Facility		$9.55	$32.36	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $31.62 / $45.71	Professional		$8.71	$31.62	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $199.53 / $199.53	Facility		$63.10	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $41.69 / $74.13	Professional		$11.75	$41.69	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.22 / $18.20	Professional	26	$7.24	$11.22	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $61.66	Professional	TC	$20.89	$30.20	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $74.13 / $75.86	Facility		$21.38	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $56.23	Professional		$28.18	$34.67	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $15.14	Professional	26	$7.59	$9.12	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.12 / $41.69	Professional	TC	$19.50	$25.12	$41.69