Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.19 / $253.79 / $520.64	Facility		$67.19	$253.79	$520.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.42 / $8.86 / $13.78	Facility	26	$7.42	$8.86	$13.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.27 / $39.07 / $555.74	Facility	TC	$23.27	$39.07	$555.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.23 / $30.71 / $63.32	Professional		$12.23	$30.71	$63.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $8.55 / $30.18	Professional	26	$7.23	$8.55	$30.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $24.40 / $115.77 / $130.00	Professional	50	$24.40	$115.77	$130.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.99 / $15.58 / $19.44	Professional	52	$12.99	$15.58	$19.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $23.37 / $45.59	Professional	TC	$19.46	$23.37	$45.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.43 / $29.32 / $48.86	Professional		$24.43	$29.32	$48.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $7.42 / $13.93	Professional	26	$5.94	$7.42	$13.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.98 / $73.30 / $73.30	Professional	50	$43.98	$73.30	$73.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.68 / $35.68 / $52.02	Professional	TC	$34.68	$35.68	$52.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.62 / $187.82 / $200.00	Facility		$29.62	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $40.86 / $69.23	Professional		$26.65	$40.86	$69.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.97	Professional	26	$9.11	$11.40	$15.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.97 / $61.31 / $103.86	Professional	50	$39.97	$61.31	$103.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $25.87 / $53.88	Professional	TC	$17.50	$25.87	$53.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.89 / $27.74 / $41.23	Facility		$7.89	$27.74	$41.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.79 / $26.59 / $39.70	Professional		$7.79	$26.59	$39.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $200.00 / $200.00	Facility		$38.40	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.71 / $39.71 / $69.56	Professional		$28.71	$39.71	$69.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $10.80 / $17.93	Professional	26	$7.67	$10.80	$17.93
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.91 / $41.91 / $47.61	Professional	50	$41.91	$41.91	$47.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.35 / $26.66 / $52.45	Professional	TC	$19.35	$26.66	$52.45
United Facility/Professional Facility Modifier Low / Median / High Price $194.81 / $194.81 / $194.81	Facility		$194.81	$194.81	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $33.92 / $55.54	Professional		$27.14	$33.92	$55.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.34 / $15.77	Professional	26	$7.79	$9.34	$15.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.67 / $24.50 / $40.40	Professional	TC	$18.67	$24.50	$40.40