Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $323.59 / $645.65	Facility		$42.66	$323.59	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.47 / $16.98	Facility	26	$8.71	$10.47	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $44.67 / $371.54	Facility	TC	$28.18	$44.67	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $50.12 / $138.04	Professional		$12.59	$50.12	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.14 / $50.12	Professional	26	$8.32	$15.14	$50.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.88 / $107.15 / $151.36	Professional	50	$21.88	$107.15	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.90 / $77.62	Professional	TC	$24.55	$38.90	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $60.26	Professional		$26.92	$34.67	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $17.78	Professional	26	$7.08	$10.23	$17.78
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $54.95 / $77.62	Professional	50	$43.65	$54.95	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $57.54	Professional	TC	$20.42	$30.20	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $58.88	Professional		$30.20	$33.11	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.23 / $17.38	Professional	26	$9.55	$10.23	$17.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $50.12 / $89.13	Professional	50	$44.67	$50.12	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $22.39 / $42.66	Professional	TC	$20.89	$22.39	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $35.48 / $52.48	Facility		$9.33	$35.48	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $29.51 / $47.86	Professional		$9.33	$29.51	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $51.29 / $63.10	Facility		$30.90	$51.29	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	TC	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $56.23 / $190.55	Professional		$31.62	$56.23	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $15.49 / $43.65	Professional	26	$8.71	$15.49	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $42.66 / $147.91	Professional	TC	$23.44	$42.66	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $33.11	Professional		$15.49	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $57.54	Professional		$28.84	$36.31	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.77 / $15.49	Professional	26	$8.32	$9.77	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.30 / $42.66	Professional	TC	$20.42	$26.30	$42.66