Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $218.78 / $512.86	Facility		$33.11	$218.78	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $10.00 / $13.49	Facility	26	$8.32	$10.00	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $33.88 / $288.40	Facility	TC	$19.05	$33.88	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $114.82	Professional		$24.55	$37.15	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.75 / $37.15	Professional	26	$7.94	$11.75	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $47.86	Professional	TC	$16.98	$22.91	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.70 / $53.70	Professional		$19.05	$25.70	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.33 / $16.60	Professional	26	$6.46	$9.33	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $20.42 / $38.90	Professional	TC	$14.13	$20.42	$38.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $35.48	Professional		$25.12	$25.12	$35.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $8.91 / $12.02	Professional	26	$8.91	$8.91	$12.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $16.22 / $21.88	Professional	TC	$16.22	$16.22	$21.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $24.55 / $38.90	Facility		$8.91	$24.55	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $19.95 / $35.48	Professional		$8.91	$19.95	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $46.77 / $46.77	Facility		$20.89	$46.77	$46.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.11	Facility	TC	$5.01	$23.44	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $141.25	Professional		$24.55	$42.66	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.79 / $40.74	Professional	26	$8.71	$14.79	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $30.90 / $100.00	Professional	TC	$17.38	$30.90	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $32.36 / $33.11	Professional		$13.18	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $28.84 / $42.66	Professional		$24.55	$28.84	$42.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $15.14	Professional	26	$8.13	$10.00	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $19.05 / $29.51	Professional	TC	$15.85	$19.05	$29.51