Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.85 / $643.20 / $941.34	Facility		$53.85	$643.20	$941.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.79 / $29.41 / $63.43	Facility	26	$27.79	$29.41	$63.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.31 / $39.72 / $898.95	Facility	TC	$24.31	$39.72	$898.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.88 / $66.91 / $135.19	Professional		$51.88	$66.91	$135.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.79 / $33.64 / $84.00	Professional	26	$27.79	$33.64	$84.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.88 / $27.00 / $59.27	Professional	52	$24.88	$27.00	$59.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $32.70 / $72.06	Professional	TC	$22.35	$32.70	$72.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.64 / $64.00 / $65.28	Professional		$38.64	$64.00	$65.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $42.04 / $47.08	Professional	26	$20.38	$42.04	$47.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.95 / $20.95 / $30.37	Professional	TC	$20.95	$20.95	$30.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.22 / $75.09 / $93.00	Professional		$57.22	$75.09	$93.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.28 / $42.76 / $53.01	Professional	26	$35.28	$42.76	$53.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.70 / $29.15 / $41.15	Professional	TC	$15.70	$29.15	$41.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.31 / $47.08 / $89.60	Facility		$34.31	$47.08	$89.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.96 / $44.15 / $89.60	Professional		$33.96	$44.15	$89.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.00 / $146.00 / $146.00	Facility		$146.00	$146.00	$146.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.29 / $78.29 / $78.29	Facility	26	$78.29	$78.29	$78.29
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $67.70 / $67.70 / $67.70	Facility	TC	$67.70	$67.70	$67.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.93 / $93.87 / $167.40	Professional		$32.93	$93.87	$167.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $45.87 / $80.18	Professional	26	$17.07	$45.87	$80.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.62 / $36.96 / $105.68	Professional	TC	$15.62	$36.96	$105.68
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 $55.19 / $74.06 / $130.34	Professional		$55.19	$74.06	$130.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $39.34 / $74.78	Professional	26	$28.41	$39.34	$74.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.06 / $50.97 / $64.83	Professional	TC	$28.06	$50.97	$64.83