Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.57 / $308.89 / $571.91	Facility		$33.57	$308.89	$571.91
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 $22.90 / $48.34 / $511.13	Facility	TC	$22.90	$48.34	$511.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $40.95 / $140.00	Professional		$18.57	$40.95	$140.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $11.05 / $39.31	Professional	26	$7.73	$11.05	$39.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.92 / $104.94 / $116.30	Professional	50	$57.92	$104.94	$116.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.34 / $26.50 / $110.00	Professional	TC	$22.34	$26.50	$110.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $40.59 / $48.71	Professional		$25.30	$40.59	$48.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $9.08 / $12.84	Professional	26	$6.19	$9.08	$12.84
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.84 / $45.84 / $53.82	Professional	50	$45.84	$45.84	$53.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.69 / $28.96 / $29.38	Professional	TC	$24.69	$28.96	$29.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $28.59 / $50.64	Professional		$26.42	$28.59	$50.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $9.42 / $14.91	Professional	26	$7.96	$9.42	$14.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.63 / $42.88 / $76.63	Professional	50	$39.63	$42.88	$76.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.86 / $19.16 / $37.02	Professional	TC	$17.86	$19.16	$37.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.59 / $32.47 / $47.08	Facility		$8.59	$32.47	$47.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.69 / $28.39 / $45.46	Professional		$8.69	$28.39	$45.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.75 / $41.75 / $163.03	Facility		$41.75	$41.75	$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 $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $42.69 / $71.50	Professional		$29.29	$42.69	$71.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.24 / $19.26	Professional	26	$8.27	$12.24	$19.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.44 / $30.53 / $51.77	Professional	TC	$20.44	$30.53	$51.77
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 $26.36 / $34.50 / $53.06	Professional		$26.36	$34.50	$53.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.08 / $13.53	Professional	26	$7.56	$9.08	$13.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $25.10 / $37.04	Professional	TC	$18.32	$25.10	$37.04