Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.35 / $343.93 / $599.34	Facility		$35.35	$343.93	$599.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $8.52 / $14.87	Facility	26	$7.31	$8.52	$14.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.90 / $40.06 / $363.96	Facility	TC	$22.90	$40.06	$363.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.61 / $39.90 / $136.60	Professional		$13.61	$39.90	$136.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.06 / $40.00	Professional	26	$7.76	$11.06	$40.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $98.12 / $112.99 / $127.43	Professional	50	$98.12	$112.99	$127.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.11 / $16.79 / $17.70	Professional	52	$15.11	$16.79	$17.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $26.13 / $62.26	Professional	TC	$21.94	$26.13	$62.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.64 / $35.13 / $47.43	Professional		$24.64	$35.13	$47.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $8.60 / $10.11	Professional	26	$6.19	$8.60	$10.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $28.37 / $30.99	Professional	TC	$20.57	$28.37	$30.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $29.75 / $51.40	Professional		$26.98	$29.75	$51.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $9.42 / $14.91	Professional	26	$7.96	$9.42	$14.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.47 / $44.05 / $77.09	Professional	50	$40.47	$44.05	$77.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $19.94 / $37.11	Professional	TC	$18.18	$19.94	$37.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.67 / $31.62 / $45.85	Facility		$8.67	$31.62	$45.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.56 / $27.42 / $44.27	Professional		$8.56	$27.42	$44.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $41.01 / $163.03	Facility		$41.01	$41.01	$163.03
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 $29.29 / $42.39 / $69.63	Professional		$29.29	$42.39	$69.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.24 / $19.26	Professional	26	$8.27	$12.24	$19.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $30.93 / $52.81	Professional	TC	$21.10	$30.93	$52.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $32.34 / $32.34	Professional		$14.98	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $47.66 / $47.66 / $47.66	Facility		$47.66	$47.66	$47.66
United Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $34.17 / $55.95	Professional		$26.69	$34.17	$55.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.34 / $13.53	Professional	26	$7.56	$9.34	$13.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $25.08 / $36.89	Professional	TC	$18.64	$25.08	$36.89