Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $316.23 / $645.65	Facility		$53.70	$316.23	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $12.88 / $17.78	Facility	26	$10.00	$12.88	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $50.12 / $478.63	Facility	TC	$26.92	$50.12	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $91.20	Professional		$33.11	$46.77	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $33.11	Professional	26	$8.91	$14.13	$33.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $177.83 / $204.17	Professional	50	$26.92	$177.83	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $64.57	Professional	TC	$23.99	$30.20	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $58.88	Professional		$26.30	$33.11	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.71 / $19.05	Professional	26	$7.41	$8.71	$19.05
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	50	$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $14.13 / $14.13 / $14.13	Professional	52	$14.13	$14.13	$14.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $43.65	Professional	TC	$21.88	$30.20	$43.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $263.03 / $426.58	Facility		$199.53	$263.03	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $48.98 / $77.62	Professional		$36.31	$48.98	$77.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.79 / $22.91	Professional	26	$11.22	$14.79	$22.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $53.70 / $74.13 / $117.49	Professional	50	$53.70	$74.13	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.88 / $54.95	Professional	TC	$24.55	$33.88	$54.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $35.48 / $52.48	Facility		$12.30	$35.48	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $33.88 / $51.29	Professional		$11.22	$33.88	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $41.69 / $199.53	Facility		$38.02	$41.69	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $87.10	Professional		$30.90	$50.12	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $22.91	Professional	26	$9.12	$14.45	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $35.48 / $64.57	Professional	TC	$25.12	$35.48	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $89.13 / $91.20	Facility		$30.90	$89.13	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $67.61	Professional		$34.67	$41.69	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.59 / $19.95	Professional	26	$9.77	$12.59	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.84 / $47.86	Professional	TC	$24.55	$28.84	$47.86