Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.51 / $282.81 / $634.00	Facility		$31.51	$282.81	$634.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.01 / $8.33 / $14.25	Facility	26	$7.01	$8.33	$14.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.14 / $133.44 / $532.60	Facility	TC	$22.14	$133.44	$532.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.51 / $33.65 / $105.96	Professional		$16.51	$33.65	$105.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $9.40 / $39.38	Professional	26	$7.43	$9.40	$39.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $24.40 / $105.97 / $208.50	Professional	50	$24.40	$105.97	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.02 / $15.58 / $16.45	Professional	52	$14.02	$15.58	$16.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $23.82 / $55.10	Professional	TC	$20.77	$23.82	$55.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $32.86 / $44.40	Professional		$24.48	$32.86	$44.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $8.90 / $13.99	Professional	26	$5.94	$8.90	$13.99
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.00 / $48.42 / $48.42	Professional	50	$38.00	$48.42	$48.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.46 / $28.66 / $31.00	Professional	TC	$24.46	$28.66	$31.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.81 / $29.62 / $50.55	Professional		$23.81	$29.62	$50.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.42 / $14.91	Professional	26	$7.78	$9.42	$14.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $35.71 / $44.43 / $75.81	Professional	50	$35.71	$44.43	$75.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $18.30 / $35.69	Professional	TC	$16.80	$18.30	$35.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $29.60 / $42.92	Facility		$8.32	$29.60	$42.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.52 / $25.46 / $41.44	Professional		$8.52	$25.46	$41.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $38.40 / $163.03	Facility		$38.40	$38.40	$163.03
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 $27.52 / $41.46 / $65.17	Professional		$27.52	$41.46	$65.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.07 / $18.75	Professional	26	$7.95	$12.07	$18.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $30.06 / $47.45	Professional	TC	$19.55	$30.06	$47.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $32.34 / $32.34	Professional		$14.70	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $24.60 / $32.44 / $50.88	Professional		$24.60	$32.44	$50.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.33 / $15.18	Professional	26	$7.56	$9.33	$15.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $23.95 / $35.36	Professional	TC	$17.55	$23.95	$35.36