Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $147.91 / $851.14	Facility		$38.90	$147.91	$851.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $14.13 / $16.22	Facility	26	$10.47	$14.13	$16.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $42.66 / $346.74	Facility	TC	$26.92	$42.66	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $147.91	Professional		$33.88	$51.29	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.79 / $30.20	Professional	26	$8.91	$14.79	$30.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $26.92 / $120.23	Professional	50	$26.92	$26.92	$120.23
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 / $31.62 / $60.26	Professional	TC	$23.99	$31.62	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $70.79	Professional		$26.30	$37.15	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $19.05	Professional	26	$8.32	$11.22	$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 TC Low / Median / High Price $20.42 / $30.90 / $60.26	Professional	TC	$20.42	$30.90	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $37.15 / $50.12	Professional		$36.31	$37.15	$50.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.75 / $14.79	Professional	26	$11.22	$11.75	$14.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $53.70 / $54.95 / $75.86	Professional	50	$53.70	$54.95	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $25.12 / $34.67	Professional	TC	$24.55	$25.12	$34.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $35.48 / $53.70	Facility		$10.96	$35.48	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $29.51 / $48.98	Professional		$10.96	$29.51	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $64.57 / $64.57	Facility		$29.51	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.08 / $33.11 / $47.86	Facility	TC	$7.08	$33.11	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $60.26 / $194.98	Professional		$35.48	$60.26	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $18.62 / $50.12	Professional	26	$10.72	$18.62	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $45.71 / $144.54	Professional	TC	$26.30	$45.71	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $33.11	Professional		$20.42	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.81 / $60.26	Professional		$33.88	$39.81	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.30 / $19.05	Professional	26	$10.00	$12.30	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $28.18 / $42.66	Professional	TC	$23.44	$28.18	$42.66