Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.16 / $250.75 / $529.84	Facility		$81.16	$250.75	$529.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.38 / $9.94 / $15.41	Facility	26	$8.38	$9.94	$15.41
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.01 / $36.08 / $241.89	Facility	TC	$28.01	$36.08	$241.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $37.90 / $112.50	Professional		$14.14	$37.90	$112.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $9.19 / $30.20	Professional	26	$8.15	$9.19	$30.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.22 / $62.88 / $151.63	Professional	50	$17.22	$62.88	$151.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.53 / $18.43 / $22.99	Professional	52	$15.53	$18.43	$22.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $29.14 / $57.26	Professional	TC	$24.44	$29.14	$57.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.24 / $36.56 / $54.84	Professional		$29.24	$36.56	$54.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $8.02 / $12.56	Professional	26	$6.69	$8.02	$12.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $47.87 / $47.87 / $82.26	Professional	50	$47.87	$47.87	$82.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.00 / $42.29 / $43.45	Professional	TC	$30.00	$42.29	$43.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.25 / $187.82 / $200.00	Facility		$33.25	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.01 / $44.79 / $97.40	Professional		$30.01	$44.79	$97.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $12.30 / $17.18	Professional	26	$9.59	$12.30	$17.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.01 / $67.19 / $146.10	Professional	50	$45.01	$67.19	$146.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.28 / $80.83	Professional	TC	$20.42	$28.28	$80.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.21 / $33.83 / $49.36	Facility		$9.21	$33.83	$49.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.78 / $32.42 / $47.53	Professional		$8.78	$32.42	$47.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.85 / $200.00 / $200.00	Facility		$45.85	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.79 / $35.79 / $35.79	Facility	TC	$35.79	$35.79	$35.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $45.37 / $83.25	Professional		$32.18	$45.37	$83.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.98 / $19.43	Professional	26	$8.51	$11.98	$19.43
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.26 / $48.26 / $54.93	Professional	50	$48.26	$48.26	$54.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $30.91 / $63.95	Professional	TC	$22.71	$30.91	$63.95
United Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $39.59 / $67.26	Professional		$30.75	$39.59	$67.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.34 / $17.04	Professional	26	$8.46	$10.34	$17.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $29.86 / $52.65	Professional	TC	$21.81	$29.86	$52.65