Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.24 / $91.30 / $135.32	Facility		$40.24	$91.30	$135.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.13 / $29.03 / $43.17	Facility	26	$26.13	$29.03	$43.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $82.23 / $158.29	Professional		$43.72	$82.23	$158.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.13 / $45.34 / $89.80	Professional	26	$26.13	$45.34	$89.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $94.51 / $179.00	Professional	50	$82.23	$94.51	$179.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $31.56 / $67.11	Professional	TC	$14.50	$31.56	$67.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.53 / $53.53 / $53.53	Professional		$53.53	$53.53	$53.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.13 / $77.95 / $136.16	Professional		$54.13	$77.95	$136.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.82 / $41.83 / $73.94	Professional	26	$23.82	$41.83	$73.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $81.19 / $112.84 / $204.25	Professional	50	$81.19	$112.84	$204.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $33.04 / $60.54	Professional	TC	$23.17	$33.04	$60.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.67 / $34.71 / $59.95	Facility		$15.67	$34.71	$59.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $34.71 / $59.95	Professional		$16.55	$34.71	$59.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.68 / $53.68 / $197.24	Facility		$53.68	$53.68	$197.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $34.29 / $34.29	Facility	26	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $114.18 / $181.80	Professional		$48.47	$114.18	$181.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.60 / $57.53 / $98.76	Professional	26	$29.60	$57.53	$98.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $54.00 / $100.20	Professional	TC	$18.48	$54.00	$100.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $55.67	Professional		$32.34	$32.34	$55.67
United Facility/Professional Professional Modifier Low / Median / High Price $51.08 / $83.51 / $118.82	Professional		$51.08	$83.51	$118.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $44.26 / $62.89	Professional	26	$28.37	$44.26	$62.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.53 / $35.31 / $65.94	Professional	TC	$17.53	$35.31	$65.94