Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.79 / $200.00 / $319.80	Facility		$36.79	$200.00	$319.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.43 / $8.47 / $13.41	Facility	26	$7.43	$8.47	$13.41
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.79 / $28.57 / $75.06	Facility	TC	$21.79	$28.57	$75.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $29.64 / $56.94	Professional		$16.80	$29.64	$56.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $7.64 / $15.12	Professional	26	$7.00	$7.64	$15.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.70 / $96.08 / $96.08	Professional	50	$48.70	$96.08	$96.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.24 / $14.84 / $18.51	Professional	52	$12.24	$14.84	$18.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.22 / $21.79 / $27.69	Professional	TC	$18.22	$21.79	$27.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $25.20 / $34.21	Professional		$23.87	$25.20	$34.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $7.12 / $11.43	Professional	26	$5.58	$7.12	$11.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.04 / $27.04 / $27.04	Professional	TC	$27.04	$27.04	$27.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.09 / $187.82 / $200.00	Facility		$28.09	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $28.09 / $44.94	Professional		$24.75	$28.09	$44.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $10.90 / $15.04	Professional	26	$8.34	$10.90	$15.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.11 / $42.13 / $67.41	Professional	50	$37.11	$42.13	$67.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $17.19 / $27.50	Professional	TC	$16.26	$17.19	$27.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.64 / $25.96 / $38.81	Facility		$7.64	$25.96	$38.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $24.87 / $37.38	Professional		$7.48	$24.87	$37.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.15 / $200.00 / $200.00	Facility		$36.15	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.05 / $37.36 / $65.51	Professional		$27.05	$37.36	$65.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.22 / $16.91	Professional	26	$7.25	$10.22	$16.91
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.11 / $40.11 / $45.51	Professional	50	$40.11	$40.11	$45.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.59 / $49.06	Professional	TC	$18.62	$26.59	$49.06
United Facility/Professional Facility Modifier Low / Median / High Price $194.81 / $194.81 / $194.81	Facility		$194.81	$194.81	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $25.24 / $32.11 / $59.43	Professional		$25.24	$32.11	$59.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $8.88 / $14.90	Professional	26	$7.36	$8.88	$14.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.10 / $22.32 / $39.88	Professional	TC	$17.10	$22.32	$39.88