Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $217.73 / $429.18	Facility		$52.48	$217.73	$429.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.13 / $7.44 / $11.08	Facility	26	$7.13	$7.44	$11.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.19 / $26.40 / $74.66	Facility	TC	$21.19	$26.40	$74.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.17 / $28.45 / $58.70	Professional		$13.17	$28.45	$58.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $7.78 / $21.90	Professional	26	$6.98	$7.78	$21.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.28 / $14.28 / $14.28	Professional	50	$14.28	$14.28	$14.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.87 / $40.65	Professional	TC	$17.57	$21.87	$40.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $28.45 / $34.51	Professional		$23.63	$28.45	$34.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.12 / $10.68	Professional	26	$5.70	$7.12	$10.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $25.38 / $32.95	Professional	TC	$21.33	$25.38	$32.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.27 / $187.82 / $200.00	Facility		$29.27	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $29.27 / $46.83	Professional		$26.22	$29.27	$46.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.73	Professional	26	$9.11	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.33 / $43.90 / $70.23	Professional	50	$39.33	$43.90	$70.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $17.87 / $29.10	Professional	TC	$16.89	$17.87	$29.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.56 / $25.60 / $38.40	Facility		$7.56	$25.60	$38.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $24.53 / $36.99	Professional		$7.48	$24.53	$36.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $200.00 / $200.00	Facility		$35.40	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $37.84 / $64.16	Professional		$26.80	$37.84	$64.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.41 / $17.93	Professional	26	$7.38	$10.41	$17.93
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $43.42	Professional	50	$38.29	$38.29	$43.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $26.64 / $47.71	Professional	TC	$18.14	$26.64	$47.71
United Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $30.99 / $50.76	Professional		$25.35	$30.99	$50.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $9.05 / $14.85	Professional	26	$7.72	$9.05	$14.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $22.56 / $36.68	Professional	TC	$17.05	$22.56	$36.68