Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $260.01 / $507.79	Facility		$68.95	$260.01	$507.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $8.84 / $13.08	Facility	26	$7.75	$8.84	$13.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.35 / $31.88 / $403.51	Facility	TC	$25.35	$31.88	$403.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.08 / $33.10 / $64.93	Professional		$9.08	$33.10	$64.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.35 / $31.12	Professional	26	$7.33	$8.35	$31.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.82 / $102.06 / $140.00	Professional	50	$39.82	$102.06	$140.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.01 / $16.55 / $20.94	Professional	52	$14.01	$16.55	$20.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $26.45 / $51.48	Professional	TC	$21.94	$26.45	$51.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.12 / $32.65 / $52.24	Professional		$26.12	$32.65	$52.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $7.43 / $11.61	Professional	26	$6.19	$7.43	$11.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.84 / $78.36 / $78.36	Professional	50	$42.84	$78.36	$78.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $37.36 / $38.42	Professional	TC	$19.93	$37.36	$38.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.65 / $187.82 / $200.00	Facility		$30.65	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.62 / $41.12 / $69.23	Professional		$27.62	$41.12	$69.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.40 / $15.73	Professional	26	$9.11	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.43 / $61.68 / $103.86	Professional	50	$41.43	$61.68	$103.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $26.19 / $53.88	Professional	TC	$19.02	$26.19	$53.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.30 / $29.89 / $44.08	Facility		$8.30	$29.89	$44.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $28.65 / $42.45	Professional		$8.13	$28.65	$42.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $200.00 / $200.00	Facility		$41.01	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $31.68 / $31.68 / $31.68	Facility	TC	$31.68	$31.68	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.34 / $41.90 / $75.06	Professional		$29.34	$41.90	$75.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.91 / $11.06 / $18.23	Professional	26	$7.91	$11.06	$18.23
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $49.18	Professional	50	$43.28	$43.28	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $28.48 / $57.19	Professional	TC	$20.74	$28.48	$57.19
United Facility/Professional Facility Modifier Low / Median / High Price $11.21 / $37.94 / $194.81	Facility		$11.21	$37.94	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $35.36 / $60.13	Professional		$28.56	$35.36	$60.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $9.10 / $15.56	Professional	26	$8.03	$9.10	$15.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $26.22 / $44.79	Professional	TC	$19.64	$26.22	$44.79