Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $229.09 / $416.87	Facility		$46.77	$229.09	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $10.96 / $14.45	Facility	26	$8.13	$10.96	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $34.67 / $83.18	Facility	TC	$23.99	$34.67	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $32.36 / $89.13	Professional		$8.51	$32.36	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.59 / $39.81	Professional	26	$7.94	$12.59	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $169.82 / $323.59	Professional	50	$125.89	$169.82	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.84 / $52.48	Professional	TC	$20.42	$28.84	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.84 / $56.23	Professional		$23.44	$28.84	$56.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.94 / $15.14	Professional	26	$6.46	$7.94	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $85.11 / $104.71	Professional	50	$85.11	$85.11	$104.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.12 / $52.48	Professional	TC	$21.88	$25.12	$52.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $199.53 / $354.81	Facility		$186.21	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $63.10	Professional		$27.54	$39.81	$63.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.30 / $19.05	Professional	26	$8.71	$12.30	$19.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $60.26 / $95.50	Professional	50	$41.69	$60.26	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $27.54 / $44.67	Professional	TC	$19.05	$27.54	$44.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $30.90 / $44.67	Facility		$10.00	$30.90	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $29.51 / $43.65	Professional		$9.12	$29.51	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $33.88 / $199.53	Facility		$32.36	$33.88	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $75.86	Professional		$26.92	$41.69	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.75 / $18.62	Professional	26	$7.41	$11.75	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $29.51 / $57.54	Professional	TC	$21.38	$29.51	$57.54
United Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $74.13 / $75.86	Facility		$25.12	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $56.23	Professional		$29.51	$34.67	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $16.22	Professional	26	$7.94	$10.23	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.12 / $40.74	Professional	TC	$20.89	$25.12	$40.74