Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $269.15 / $537.03	Facility		$79.43	$269.15	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $11.22 / $15.49	Facility	26	$8.32	$11.22	$15.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $42.66 / $389.05	Facility	TC	$28.18	$42.66	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $45.71 / $134.90	Professional		$10.00	$45.71	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $16.98 / $50.12	Professional	26	$7.94	$16.98	$50.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.38 / $107.15 / $234.42	Professional	50	$17.38	$107.15	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $43.65 / $89.13	Professional	TC	$25.70	$43.65	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $52.48	Professional		$26.30	$31.62	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.91 / $15.14	Professional	26	$6.76	$8.91	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $47.86 / $83.18	Professional	50	$39.81	$47.86	$83.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $47.86	Professional	TC	$21.38	$30.20	$47.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $199.53 / $354.81	Facility		$33.11	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $102.33	Professional		$30.90	$46.77	$102.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.30 / $19.50	Professional	26	$9.55	$12.30	$19.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $70.79 / $154.88	Professional	50	$46.77	$70.79	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $83.18	Professional	TC	$20.89	$31.62	$83.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $35.48 / $51.29	Facility		$10.47	$35.48	$51.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $34.67 / $50.12	Professional		$9.33	$34.67	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $51.29 / $85.11	Facility		$34.67	$51.29	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $89.13	Professional		$30.20	$45.71	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $20.42	Professional	26	$7.94	$12.02	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $67.61	Professional	TC	$22.91	$33.88	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $74.13 / $75.86	Facility		$23.99	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $63.10	Professional		$30.90	$38.90	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $16.60	Professional	26	$8.32	$10.00	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $47.86	Professional	TC	$21.88	$28.84	$47.86