Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.67 / $121.04 / $406.69	Facility		$29.67	$121.04	$406.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.01 / $8.96 / $13.70	Facility	26	$7.01	$8.96	$13.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.98 / $23.63 / $124.99	Facility	TC	$19.98	$23.63	$124.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.55 / $31.31 / $114.11	Professional		$25.55	$31.31	$114.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.22 / $33.45	Professional	26	$7.03	$8.22	$33.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.70 / $96.08 / $100.92	Professional	50	$48.70	$96.08	$100.92
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.36 / $14.84 / $16.53	Professional	52	$13.36	$14.84	$16.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $22.48 / $40.49	Professional	TC	$18.53	$22.48	$40.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.71 / $30.94 / $41.84	Professional		$23.71	$30.94	$41.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.89 / $10.03	Professional	26	$5.70	$7.89	$10.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $20.72 / $24.66	Professional	TC	$20.72	$20.72	$24.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $27.72 / $44.56	Professional		$22.01	$27.72	$44.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $8.59 / $13.58	Professional	26	$7.30	$8.59	$13.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.65 / $41.58 / $66.84	Professional	50	$32.65	$41.58	$66.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.47 / $17.19 / $30.98	Professional	TC	$14.47	$17.19	$30.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.92 / $27.89 / $40.44	Facility		$7.92	$27.89	$40.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.19 / $23.83 / $39.04	Professional		$8.19	$23.83	$39.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.15 / $36.15 / $163.03	Facility		$36.15	$36.15	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.06 / $39.79 / $61.40	Professional		$26.06	$39.79	$61.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $11.78 / $17.71	Professional	26	$7.58	$11.78	$17.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.66 / $28.16 / $45.29	Professional	TC	$18.66	$28.16	$45.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.87 / $32.34 / $32.34	Professional		$13.87	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $31.92 / $46.45	Professional		$23.78	$31.92	$46.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $9.02 / $12.99	Professional	26	$7.19	$9.02	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.53 / $20.78 / $31.54	Professional	TC	$16.53	$20.78	$31.54