Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $309.03 / $616.60	Facility		$39.81	$309.03	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $9.33 / $14.45	Facility	26	$7.76	$9.33	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $38.90 / $575.44	Facility	TC	$23.44	$38.90	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $42.66 / $123.03	Professional		$10.72	$42.66	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.49 / $45.71	Professional	26	$7.08	$13.49	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $22.91 / $89.13 / $169.82	Professional	50	$22.91	$89.13	$169.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $32.36	Professional	52	$3.80	$3.80	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $35.48 / $61.66	Professional	TC	$20.89	$35.48	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $51.29	Professional		$21.38	$27.54	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.51 / $12.59	Professional	26	$6.03	$8.51	$12.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $42.66 / $69.18	Professional	50	$34.67	$42.66	$69.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $46.77	Professional	TC	$18.20	$25.70	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $28.84 / $50.12	Professional		$26.92	$28.84	$50.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.33 / $15.85	Professional	26	$8.91	$9.33	$15.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $43.65 / $75.86	Professional	50	$40.74	$43.65	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $19.05 / $36.31	Professional	TC	$18.20	$19.05	$36.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $29.51 / $44.67	Facility		$8.32	$29.51	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $24.55 / $39.81	Professional		$8.32	$24.55	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $52.48 / $52.48	Facility		$25.12	$52.48	$52.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.95 / $9.12 / $13.18	Facility	26	$1.95	$9.12	$13.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	TC	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $41.69 / $158.49	Professional		$23.99	$41.69	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.45 / $41.69	Professional	26	$7.94	$14.45	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $35.48 / $120.23	Professional	TC	$19.95	$35.48	$120.23
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 $26.30 / $32.36 / $48.98	Professional		$26.30	$32.36	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $13.80	Professional	26	$7.59	$9.12	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $34.67	Professional	TC	$18.20	$22.91	$34.67