Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $194.98 / $512.86	Facility		$32.36	$194.98	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.00 / $14.13	Facility	26	$7.41	$10.00	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $32.36 / $251.19	Facility	TC	$20.89	$32.36	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $34.67 / $102.33	Professional		$10.72	$34.67	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $42.66	Professional	26	$7.08	$12.02	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.88 / $77.62 / $257.04	Professional	50	$21.88	$77.62	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.92 / $53.70	Professional	TC	$17.78	$26.92	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $26.92 / $56.23	Professional		$20.42	$26.92	$56.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $8.13 / $13.49	Professional	26	$5.89	$8.13	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $47.86 / $102.33	Professional	50	$47.86	$47.86	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $36.31	Professional	TC	$15.85	$22.91	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $28.84 / $50.12	Professional		$26.30	$28.84	$50.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.33 / $16.22	Professional	26	$9.12	$9.33	$16.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $42.66 / $75.86	Professional	50	$39.81	$42.66	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $17.78 / $33.11	Professional	TC	$17.38	$17.78	$33.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.94 / $27.54 / $41.69	Facility		$7.94	$27.54	$41.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.39 / $37.15	Professional		$7.94	$22.39	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $41.69 / $48.98	Facility		$23.44	$41.69	$48.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	TC	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $46.77 / $147.91	Professional		$25.70	$46.77	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.13 / $41.69	Professional	26	$7.76	$14.13	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $32.36 / $112.20	Professional	TC	$18.62	$32.36	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $32.36 / $33.11	Professional		$14.13	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $28.84 / $46.77	Professional		$24.55	$28.84	$46.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.12 / $13.18	Professional	26	$7.24	$9.12	$13.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $32.36	Professional	TC	$16.98	$19.95	$32.36