Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $363.08 / $912.01	Facility		$54.95	$363.08	$912.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $35.48 / $57.54	Facility	26	$28.84	$35.48	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $93.33 / $354.81	Professional		$48.98	$93.33	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $165.96	Professional	26	$28.18	$44.67	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $181.97	Professional	TC	$20.89	$33.88	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $97.72	Professional		$40.74	$51.29	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $54.95	Professional	26	$22.91	$30.90	$54.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $63.10	Professional	TC	$52.48	$52.48	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $69.18 / $186.21	Professional		$67.61	$69.18	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $32.36 / $54.95	Professional	26	$27.54	$32.36	$54.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $37.15 / $120.23	Professional	TC	$33.88	$37.15	$120.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $39.81 / $75.86	Facility		$25.70	$39.81	$75.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $35.48 / $69.18	Professional		$26.92	$35.48	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	26	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $151.36 / $602.56	Professional		$52.48	$151.36	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $48.98 / $158.49	Professional	26	$30.20	$48.98	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $109.65 / $489.78	Professional	TC	$26.92	$109.65	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $42.66	Professional		$32.36	$33.11	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $107.15 / $186.21	Professional		$48.98	$107.15	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $34.67 / $52.48	Professional	26	$28.18	$34.67	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $45.71 / $151.36	Professional	TC	$21.38	$45.71	$151.36