Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $316.23 / $346.74	Facility		$43.65	$316.23	$346.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $51.29	Facility	26	$28.18	$28.18	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $81.28 / $208.93	Professional		$40.74	$81.28	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.90 / $141.25	Professional	26	$25.70	$38.90	$141.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $64.57 / $147.91 / $302.00	Professional	50	$64.57	$147.91	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.05 / $47.86	Professional	TC	$14.13	$19.05	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.02 / $46.77	Professional		$32.36	$38.02	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $39.81 / $89.13	Professional	26	$19.95	$39.81	$89.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $53.70 / $60.26	Professional	50	$46.77	$53.70	$60.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $346.74 / $346.74	Facility		$87.10	$346.74	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $102.33 / $162.18	Professional		$53.70	$102.33	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $45.71 / $74.13	Professional	26	$23.99	$45.71	$74.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $151.36 / $245.47	Professional	50	$81.28	$151.36	$245.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $56.23 / $89.13	Professional	TC	$30.20	$56.23	$89.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $36.31 / $61.66	Facility		$19.50	$36.31	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $33.11 / $56.23	Professional		$16.98	$33.11	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $346.74 / $346.74	Facility		$63.10	$346.74	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $128.82 / $194.98	Professional		$53.70	$128.82	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $48.98 / $93.33	Professional	26	$25.70	$48.98	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $38.90 / $100.00	Professional	TC	$16.60	$38.90	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $89.13 / $112.20	Facility		$47.86	$89.13	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $81.28 / $144.54	Professional		$46.77	$81.28	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $46.77 / $64.57	Professional	26	$28.18	$46.77	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $33.88 / $72.44	Professional	TC	$18.20	$33.88	$72.44