Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $302.00 / $616.60	Facility		$38.90	$302.00	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $9.77 / $14.79	Facility	26	$8.13	$9.77	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $39.81 / $354.81	Facility	TC	$25.70	$39.81	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $40.74 / $117.49	Professional		$11.22	$40.74	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.80 / $43.65	Professional	26	$7.76	$13.80	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $107.15 / $177.83	Professional	50	$40.74	$107.15	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $37.15 / $69.18	Professional	TC	$21.88	$37.15	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.84 / $53.70	Professional		$22.91	$28.84	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.91 / $15.49	Professional	26	$6.17	$8.91	$15.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $41.69 / $117.49	Professional	50	$37.15	$41.69	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $27.54 / $46.77	Professional	TC	$17.78	$27.54	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $29.51 / $52.48	Professional		$27.54	$29.51	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.55 / $16.60	Professional	26	$9.12	$9.55	$16.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $43.65 / $79.43	Professional	50	$41.69	$43.65	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $19.95 / $38.02	Professional	TC	$18.62	$19.95	$38.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $31.62 / $47.86	Facility		$8.51	$31.62	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $26.30 / $42.66	Professional		$8.51	$26.30	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $43.65 / $56.23	Facility		$26.92	$43.65	$56.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.46 / $30.20 / $43.65	Facility	TC	$6.46	$30.20	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $50.12 / $169.82	Professional		$28.18	$50.12	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.45 / $41.69	Professional	26	$8.32	$14.45	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.02 / $131.83	Professional	TC	$20.89	$38.02	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $32.36 / $33.11	Professional		$14.45	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.36 / $50.12	Professional		$26.92	$32.36	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.12 / $14.45	Professional	26	$7.76	$9.12	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.44 / $37.15	Professional	TC	$18.62	$23.44	$37.15