Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.78 / $143.02 / $534.46	Facility		$30.78	$143.02	$534.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $9.01 / $18.84	Facility	26	$8.46	$9.01	$18.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.76 / $21.97 / $235.20	Facility	TC	$21.76	$21.97	$235.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.04 / $36.26 / $72.05	Professional		$29.04	$36.26	$72.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $9.18 / $18.84	Professional	26	$8.21	$9.18	$18.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $27.81 / $58.75	Professional	TC	$21.76	$27.81	$58.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.73 / $37.21 / $37.95	Professional		$22.73	$37.21	$37.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $10.46 / $14.35	Professional	26	$6.15	$10.46	$14.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $18.60 / $18.60	Professional	TC	$18.60	$18.60	$18.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.45 / $36.68 / $48.81	Professional		$29.45	$36.68	$48.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.95 / $17.79 / $19.91	Professional	26	$12.95	$17.79	$19.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $17.98 / $34.99	Professional	TC	$10.11	$17.98	$34.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.48 / $37.74 / $52.09	Facility		$12.48	$37.74	$52.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.20 / $33.70 / $52.09	Professional		$12.20	$33.70	$52.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.66 / $94.66 / $94.66	Facility		$94.66	$94.66	$94.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.96 / $16.96 / $16.96	Facility	26	$16.96	$16.96	$16.96
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $77.70 / $77.70 / $77.70	Facility	TC	$77.70	$77.70	$77.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $44.26 / $85.76	Professional		$19.34	$44.26	$85.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.26 / $13.35 / $26.00	Professional	26	$5.26	$13.35	$26.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.05 / $29.38 / $78.59	Professional	TC	$14.05	$29.38	$78.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $33.21 / $46.65 / $79.72	Professional		$33.21	$46.65	$79.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $11.58 / $21.22	Professional	26	$7.06	$11.58	$21.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.85 / $32.95 / $51.80	Professional	TC	$25.85	$32.95	$51.80