Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.32 / $253.57 / $511.68	Facility		$48.32	$253.57	$511.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.36 / $10.49 / $19.03	Facility	26	$9.36	$10.49	$19.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.53 / $61.67 / $392.49	Facility	TC	$31.53	$61.67	$392.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.21 / $48.00 / $161.04	Professional		$13.21	$48.00	$161.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $11.87 / $43.12	Professional	26	$9.98	$11.87	$43.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.02 / $33.70 / $73.39	Professional	TC	$29.02	$33.70	$73.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $51.83 / $62.19	Professional		$36.47	$51.83	$62.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $11.03 / $12.95	Professional	26	$7.97	$11.03	$12.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $31.50 / $34.81	Professional	TC	$27.14	$31.50	$34.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $34.88 / $54.00	Professional		$32.72	$34.88	$54.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $9.94 / $14.52	Professional	26	$9.66	$9.94	$14.52
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $49.08 / $51.95 / $80.08	Professional	50	$49.08	$51.95	$80.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.07 / $23.77 / $40.69	Professional	TC	$23.07	$23.77	$40.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.01 / $41.46 / $60.12	Facility		$11.01	$41.46	$60.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $36.22 / $58.04	Professional		$11.11	$36.22	$58.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.31 / $53.31 / $163.03	Facility		$53.31	$53.31	$163.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $41.38	Facility	TC	$41.38	$41.38	$41.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $55.21 / $85.72	Professional		$40.35	$55.21	$85.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.73 / $15.24 / $25.30	Professional	26	$10.73	$15.24	$25.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $41.09 / $60.42	Professional	TC	$29.84	$41.09	$60.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.57 / $32.34 / $32.34	Professional		$22.57	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $45.83 / $68.59	Professional		$37.03	$45.83	$68.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $12.30 / $17.39	Professional	26	$10.06	$12.30	$17.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $33.22 / $48.35	Professional	TC	$26.78	$33.22	$48.35