Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $173.78 / $478.63	Facility		$37.15	$173.78	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.12 / $13.49	Facility	26	$8.32	$9.12	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $36.31 / $263.03	Facility	TC	$23.99	$36.31	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $36.31 / $107.15	Professional		$8.91	$36.31	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.59 / $41.69	Professional	26	$7.94	$12.59	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $177.83 / $177.83	Professional	50	$169.82	$177.83	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $52.48	Professional	TC	$20.89	$28.18	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $40.74	Professional		$23.44	$28.18	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.33 / $15.85	Professional	26	$6.61	$9.33	$15.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $51.29 / $51.29	Professional	50	$51.29	$51.29	$51.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $23.99 / $34.67	Professional	TC	$21.88	$23.99	$34.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $28.18 / $41.69	Professional		$27.54	$28.18	$41.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.12 / $12.30	Professional	26	$8.71	$9.12	$12.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $42.66 / $63.10	Professional	50	$41.69	$42.66	$63.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $19.50 / $28.84	Professional	TC	$19.05	$19.50	$28.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $30.90 / $46.77	Facility		$8.91	$30.90	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $26.30 / $41.69	Professional		$8.91	$26.30	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $54.95 / $54.95	Facility		$26.30	$54.95	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.31 / $29.51 / $41.69	Facility	TC	$6.31	$29.51	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $48.98 / $165.96	Professional		$29.51	$48.98	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $15.14 / $40.74	Professional	26	$8.71	$15.14	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.02 / $125.89	Professional	TC	$21.88	$38.02	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $32.36 / $33.11	Professional		$16.60	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $51.29	Professional		$28.84	$33.88	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $15.49	Professional	26	$8.13	$10.23	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.99 / $37.15	Professional	TC	$19.95	$23.99	$37.15