Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $239.88 / $426.58	Facility		$46.77	$239.88	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $9.55 / $12.59	Facility	26	$7.08	$9.55	$12.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $30.20 / $75.86	Facility	TC	$21.38	$30.20	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $33.11 / $95.50	Professional		$10.23	$33.11	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $43.65	Professional	26	$7.08	$14.13	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.13 / $77.62 / $162.18	Professional	50	$14.13	$77.62	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $31.62 / $61.66	Professional	TC	$19.05	$31.62	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $26.30 / $47.86	Professional		$20.42	$26.30	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $6.76 / $12.59	Professional	26	$5.75	$6.76	$12.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $37.15 / $56.23	Professional	50	$37.15	$37.15	$56.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $24.55 / $40.74	Professional	TC	$17.78	$24.55	$40.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $199.53 / $354.81	Facility		$29.51	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $29.51 / $48.98	Professional		$26.30	$29.51	$48.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $17.78	Professional	26	$8.91	$11.48	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $43.65 / $74.13	Professional	50	$39.81	$43.65	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.78 / $33.88	Professional	TC	$17.38	$17.78	$33.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $27.54 / $39.81	Facility		$8.91	$27.54	$39.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $26.30 / $38.90	Professional		$7.94	$26.30	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $41.69 / $125.89	Facility		$22.91	$41.69	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $72.44	Professional		$25.12	$38.02	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.72 / $18.20	Professional	26	$6.61	$10.72	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $51.29	Professional	TC	$18.20	$27.54	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $74.13 / $75.86	Facility		$20.89	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.90 / $50.12	Professional		$24.55	$30.90	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.12 / $14.45	Professional	26	$7.41	$9.12	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.88 / $36.31	Professional	TC	$17.38	$21.88	$36.31