Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.78 / $292.72 / $483.43	Facility		$28.78	$292.72	$483.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.74 / $7.86 / $13.70	Facility	26	$6.74	$7.86	$13.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.44 / $32.07 / $253.57	Facility	TC	$20.44	$32.07	$253.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $34.69 / $110.98	Professional		$18.57	$34.69	$110.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $10.18 / $37.15	Professional	26	$7.16	$10.18	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.62 / $112.62 / $112.62	Professional	50	$112.62	$112.62	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.59 / $21.87 / $44.96	Professional	TC	$17.59	$21.87	$44.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $30.62 / $34.51	Professional		$21.51	$30.62	$34.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.73 / $8.96	Professional	26	$5.70	$7.73	$8.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $24.32 / $25.38	Professional	TC	$24.32	$24.32	$25.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.05 / $28.34 / $47.09	Professional		$23.05	$28.34	$47.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.42 / $14.85	Professional	26	$7.78	$9.42	$14.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.57 / $41.53 / $70.63	Professional	50	$34.57	$41.53	$70.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.22 / $17.87 / $31.49	Professional	TC	$15.22	$17.87	$31.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.92 / $27.59 / $40.03	Facility		$7.92	$27.59	$40.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.19 / $23.51 / $38.65	Professional		$8.19	$23.51	$38.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $163.03	Facility		$35.40	$35.40	$163.03
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 / $40.21 / $60.78	Professional		$26.80	$40.21	$60.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.87 / $18.03	Professional	26	$7.95	$11.87	$18.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $27.52 / $41.69	Professional	TC	$18.14	$27.52	$41.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $32.34 / $32.34	Professional		$14.70	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $24.49 / $31.04 / $46.56	Professional		$24.49	$31.04	$46.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $9.13 / $12.45	Professional	26	$7.17	$9.13	$12.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $21.53 / $31.84	Professional	TC	$16.89	$21.53	$31.84