Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $257.04 / $478.63	Facility		$72.44	$257.04	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.00 / $14.45	Facility	26	$7.41	$10.00	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $36.31 / $676.08	Facility	TC	$23.44	$36.31	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $41.69 / $114.82	Professional		$8.13	$41.69	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.45 / $45.71	Professional	26	$7.08	$14.45	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.18 / $97.72 / $204.17	Professional	50	$28.18	$97.72	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	52	$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $38.90 / $79.43	Professional	TC	$21.38	$38.90	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.18 / $46.77	Professional		$21.38	$28.18	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.08 / $11.48	Professional	26	$5.89	$7.08	$11.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $43.65 / $69.18	Professional	50	$34.67	$43.65	$69.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $40.74	Professional	TC	$16.98	$25.70	$40.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $199.53 / $354.81	Facility		$30.20	$199.53	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $53.70	Professional		$26.92	$34.67	$53.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $17.78	Professional	26	$8.91	$11.48	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $51.29 / $79.43	Professional	50	$40.74	$51.29	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $35.48	Professional	TC	$18.20	$22.91	$35.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $29.51 / $42.66	Facility		$9.33	$29.51	$42.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $28.84 / $41.69	Professional		$8.32	$28.84	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $199.53 / $199.53	Facility		$57.54	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $41.69 / $70.79	Professional		$22.91	$41.69	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.96 / $18.20	Professional	26	$6.92	$10.96	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $54.95	Professional	TC	$19.95	$28.84	$54.95
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 $27.54 / $33.11 / $53.70	Professional		$27.54	$33.11	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.12 / $14.79	Professional	26	$7.41	$9.12	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.99 / $38.90	Professional	TC	$19.50	$23.99	$38.90