Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.11 / $200.00 / $367.68	Facility		$35.11	$200.00	$367.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.84 / $8.19 / $10.66	Facility	26	$6.84	$8.19	$10.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.53 / $23.87 / $64.72	Facility	TC	$18.53	$23.87	$64.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $27.22 / $53.16	Professional		$21.48	$27.22	$53.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $7.13 / $13.73	Professional	26	$6.48	$7.13	$13.73
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.74 / $13.22 / $16.10	Professional	52	$10.74	$13.22	$16.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $19.45 / $26.16	Professional	TC	$16.77	$19.45	$26.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $28.53 / $38.21	Professional		$21.20	$28.53	$38.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.46 / $7.14 / $10.98	Professional	26	$5.46	$7.14	$10.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $28.83 / $28.83	Professional	TC	$28.83	$28.83	$28.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.09 / $187.82 / $200.00	Facility		$28.09	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $28.09 / $44.66	Professional		$24.75	$28.09	$44.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $10.90 / $15.04	Professional	26	$8.26	$10.90	$15.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.11 / $42.13 / $66.98	Professional	50	$37.11	$42.13	$66.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $17.19 / $27.50	Professional	TC	$16.26	$17.19	$27.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.33 / $22.38 / $34.38	Facility		$7.33	$22.38	$34.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.16 / $21.46 / $33.11	Professional		$7.16	$21.46	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.07 / $200.00 / $200.00	Facility		$32.07	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $8.51	Facility	26	$8.51	$8.51	$8.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $35.36 / $58.42	Professional		$24.31	$35.36	$58.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $9.78 / $16.21	Professional	26	$7.02	$9.78	$16.21
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $39.76	Professional	50	$35.13	$35.13	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $24.37 / $41.63	Professional	TC	$17.61	$24.37	$41.63
United Facility/Professional Professional Modifier Low / Median / High Price $23.64 / $28.36 / $49.26	Professional		$23.64	$28.36	$49.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $8.35 / $13.77	Professional	26	$6.91	$8.35	$13.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.43 / $20.23 / $34.60	Professional	TC	$16.43	$20.23	$34.60