Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.50 / $318.80 / $580.46	Facility		$39.50	$318.80	$580.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.05 / $8.22 / $14.31	Facility	26	$7.05	$8.22	$14.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.61 / $43.92 / $571.91	Facility	TC	$21.61	$43.92	$571.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $41.54 / $131.96	Professional		$18.19	$41.54	$131.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $10.64 / $40.00	Professional	26	$7.45	$10.64	$40.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.70 / $105.41 / $119.52	Professional	50	$52.70	$105.41	$119.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.04 / $15.60 / $16.44	Professional	52	$14.04	$15.60	$16.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $24.52 / $57.14	Professional	TC	$21.32	$24.52	$57.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $35.85 / $41.48	Professional		$23.10	$35.85	$41.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.96 / $8.25 / $10.82	Professional	26	$5.96	$8.25	$10.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.82 / $41.82 / $41.82	Professional	50	$41.82	$41.82	$41.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $22.14 / $43.17	Professional	TC	$18.82	$22.14	$43.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $28.80 / $46.31	Professional		$26.66	$28.80	$46.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $9.26 / $14.76	Professional	26	$7.87	$9.26	$14.76
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.99 / $43.20 / $69.45	Professional	50	$39.99	$43.20	$69.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.89 / $18.91 / $32.86	Professional	TC	$15.89	$18.91	$32.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.28 / $29.63 / $42.96	Facility		$8.28	$29.63	$42.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.28 / $25.46 / $41.48	Professional		$8.28	$25.46	$41.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $38.40 / $163.03	Facility		$38.40	$38.40	$163.03
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 $27.81 / $41.38 / $65.23	Professional		$27.81	$41.38	$65.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.92 / $18.84	Professional	26	$7.95	$11.92	$18.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $29.49 / $49.04	Professional	TC	$19.82	$29.49	$49.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $32.34 / $32.34	Professional		$14.98	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $32.02 / $46.48	Professional		$26.36	$32.02	$46.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $9.07 / $12.99	Professional	26	$7.56	$9.07	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.22 / $24.16 / $33.21	Professional	TC	$18.22	$24.16	$33.21