Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.25 / $255.97 / $499.53	Facility		$74.25	$255.97	$499.53
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $8.84 / $13.08	Facility	26	$7.75	$8.84	$13.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.35 / $33.04 / $361.02	Facility	TC	$25.35	$33.04	$361.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $34.03 / $70.00	Professional		$12.02	$34.03	$70.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.43 / $26.92	Professional	26	$7.33	$8.43	$26.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.52 / $104.10 / $140.00	Professional	50	$16.52	$104.10	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $26.56 / $57.29	Professional	TC	$21.64	$26.56	$57.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.41 / $33.54 / $53.68	Professional		$27.41	$33.54	$53.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $7.74 / $11.91	Professional	26	$6.19	$7.74	$11.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $44.00 / $54.44 / $80.52	Professional	50	$44.00	$54.44	$80.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.84 / $38.72 / $58.07	Professional	TC	$34.84	$38.72	$58.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.31 / $187.82 / $200.00	Facility		$30.31	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $40.83 / $69.23	Professional		$27.30	$40.83	$69.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.73	Professional	26	$9.11	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.95 / $61.25 / $103.86	Professional	50	$40.95	$61.25	$103.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.61 / $25.81 / $53.88	Professional	TC	$18.61	$25.81	$53.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $30.97 / $45.29	Facility		$8.51	$30.97	$45.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $29.68 / $43.62	Professional		$8.13	$29.68	$43.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.75 / $200.00 / $200.00	Facility		$41.75	$200.00	$200.00
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 $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.34 / $41.90 / $74.38	Professional		$29.34	$41.90	$74.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.91 / $11.06 / $18.23	Professional	26	$7.91	$11.06	$18.23
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $49.18	Professional	50	$43.28	$43.28	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $28.72 / $56.51	Professional	TC	$20.74	$28.72	$56.51
United Facility/Professional Facility Modifier Low / Median / High Price $194.81 / $194.81 / $194.81	Facility		$194.81	$194.81	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $35.36 / $62.88	Professional		$28.30	$35.36	$62.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $9.25 / $15.56	Professional	26	$7.74	$9.25	$15.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $25.40 / $43.02	Professional	TC	$19.46	$25.40	$43.02