Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.64 / $185.27 / $447.79	Facility		$31.64	$185.27	$447.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.62 / $8.55 / $15.48	Facility	26	$7.62	$8.55	$15.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.98 / $25.94 / $253.57	Facility	TC	$22.98	$25.94	$253.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $34.50 / $132.00	Professional		$26.26	$34.50	$132.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $9.72 / $41.50	Professional	26	$8.08	$9.72	$41.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.57 / $24.60 / $50.63	Professional	TC	$21.57	$24.60	$50.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $34.53 / $38.86	Professional		$25.67	$34.53	$38.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $8.55 / $11.34	Professional	26	$6.45	$8.55	$11.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $28.46 / $42.05	Professional		$27.63	$28.46	$42.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $9.02 / $12.31	Professional	26	$8.56	$9.02	$12.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.44 / $42.69 / $62.05	Professional	50	$41.44	$42.69	$62.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $19.54 / $30.23	Professional	TC	$18.97	$19.54	$30.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.02 / $31.04 / $45.08	Facility		$9.02	$31.04	$45.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $26.44 / $43.53	Professional		$9.27	$26.44	$43.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $39.89 / $163.03	Facility		$39.89	$39.89	$163.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.05 / $41.84 / $67.28	Professional		$31.05	$41.84	$67.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $12.82 / $21.27	Professional	26	$8.73	$12.82	$21.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $30.82 / $46.01	Professional	TC	$22.32	$30.82	$46.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.20 / $32.34 / $32.34	Professional		$17.20	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $35.01 / $48.33	Professional		$29.06	$35.01	$48.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.32 / $14.63	Professional	26	$8.34	$10.32	$14.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $24.84 / $36.83	Professional	TC	$19.80	$24.84	$36.83