Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $316.23 / $616.60	Facility		$79.43	$316.23	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $33.11 / $50.12	Facility	26	$30.90	$33.11	$50.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $93.33 / $407.38	Professional		$53.70	$93.33	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $158.49	Professional	26	$30.20	$56.23	$158.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $158.49 / $691.83	Professional	50	$66.07	$158.49	$691.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $57.54 / $239.88	Professional	TC	$42.66	$57.54	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $128.82	Professional		$61.66	$77.62	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.88 / $61.66	Professional	26	$23.99	$33.88	$61.66
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $114.82 / $173.78	Professional	50	$81.28	$114.82	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $81.28 / $102.33	Professional	TC	$45.71	$81.28	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $79.43 / $107.15	Professional		$75.86	$79.43	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $29.51 / $41.69	Professional	26	$28.18	$29.51	$41.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $117.49 / $158.49	Professional	50	$114.82	$117.49	$158.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $48.98 / $63.10	Professional	TC	$47.86	$48.98	$63.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $58.88 / $107.15	Facility		$30.90	$58.88	$107.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $97.72	Professional		$32.36	$51.29	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $131.83 / $131.83	Facility		$51.29	$131.83	$131.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $398.11	Professional		$75.86	$114.82	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $48.98 / $151.36	Professional	26	$31.62	$48.98	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $74.13 / $245.47	Professional	TC	$47.86	$74.13	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $41.69	Professional		$32.36	$33.11	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $141.25	Professional		$72.44	$91.20	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $56.23	Professional	26	$30.20	$37.15	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $83.18	Professional	TC	$43.65	$54.95	$83.18