Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $257.04 / $489.78	Facility		$66.07	$257.04	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $10.47 / $14.45	Facility	26	$7.76	$10.47	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $38.02 / $407.38	Facility	TC	$25.12	$38.02	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $39.81 / $97.72	Professional		$8.91	$39.81	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $15.49 / $43.65	Professional	26	$7.76	$15.49	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $97.72 / $213.80	Professional	50	$30.90	$97.72	$213.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.79 / $97.72 / $97.72	Professional	52	$14.79	$97.72	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $77.62	Professional	TC	$22.91	$41.69	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $50.12	Professional		$22.91	$29.51	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.24 / $13.18	Professional	26	$6.17	$7.24	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $42.66 / $77.62	Professional	50	$36.31	$42.66	$77.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $47.86	Professional	TC	$18.62	$28.18	$47.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $199.53 / $354.81	Facility		$30.90	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $75.86	Professional		$28.18	$42.66	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.48 / $17.78	Professional	26	$8.71	$11.48	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $64.57 / $112.20	Professional	50	$42.66	$64.57	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $58.88	Professional	TC	$19.05	$28.84	$58.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $31.62 / $45.71	Facility		$9.55	$31.62	$45.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $30.90 / $44.67	Professional		$8.71	$30.90	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $41.69 / $131.83	Facility		$30.90	$41.69	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $79.43	Professional		$27.54	$41.69	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.22 / $18.62	Professional	26	$7.24	$11.22	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.90 / $60.26	Professional	TC	$20.42	$30.90	$60.26
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $74.13 / $75.86	Facility		$21.38	$74.13	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $56.23	Professional		$28.18	$34.67	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $15.14	Professional	26	$7.59	$9.12	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.12 / $41.69	Professional	TC	$19.50	$25.12	$41.69