Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.25 / $253.22 / $465.08	Facility		$74.25	$253.22	$465.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.45 / $8.94 / $493.32	Facility	26	$7.45	$8.94	$493.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.27 / $32.40 / $414.77	Facility	TC	$23.27	$32.40	$414.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $32.01 / $64.04	Professional		$12.59	$32.01	$64.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $8.08 / $30.00	Professional	26	$7.16	$8.08	$30.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.17 / $101.15 / $339.00	Professional	50	$25.17	$101.15	$339.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.14 / $15.91 / $19.46	Professional	52	$13.14	$15.91	$19.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $25.17 / $49.00	Professional	TC	$21.03	$25.17	$49.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.45 / $29.34 / $48.91	Professional		$24.45	$29.34	$48.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.96 / $6.54 / $11.18	Professional	26	$5.96	$6.54	$11.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $40.13 / $73.37 / $73.37	Professional	50	$40.13	$73.37	$73.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.60 / $34.68 / $52.02	Professional	TC	$24.60	$34.68	$52.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.31 / $187.82 / $200.00	Facility		$30.31	$187.82	$200.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.14 / $34.40 / $48.49	Professional		$27.14	$34.40	$48.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $11.40 / $15.73	Professional	26	$8.99	$11.40	$15.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.71 / $51.60 / $72.73	Professional	50	$40.71	$51.60	$72.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $23.00 / $31.74	Professional	TC	$18.14	$23.00	$31.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.91 / $27.74 / $41.27	Facility		$7.91	$27.74	$41.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.82 / $26.59 / $39.74	Professional		$7.82	$26.59	$39.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $200.00 / $200.00	Facility		$38.40	$200.00	$200.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.75 / $40.40 / $70.31	Professional		$28.75	$40.40	$70.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $10.68 / $17.68	Professional	26	$7.66	$10.68	$17.68
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.56 / $40.56 / $46.03	Professional	50	$40.56	$40.56	$46.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $26.69 / $53.13	Professional	TC	$20.72	$26.69	$53.13
United Facility/Professional Facility Modifier Low / Median / High Price $194.81 / $194.81 / $194.81	Facility		$194.81	$194.81	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $33.20 / $56.51	Professional		$27.64	$33.20	$56.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $9.10 / $15.17	Professional	26	$7.62	$9.10	$15.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $24.16 / $41.72	Professional	TC	$19.30	$24.16	$41.72