Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.84 / $145.58 / $643.24	Facility		$57.84	$145.58	$643.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.00 / $14.71 / $20.05	Facility	26	$9.00	$14.71	$20.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.84 / $79.84 / $110.08	Facility	TC	$48.84	$79.84	$110.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.80 / $68.90 / $140.25	Professional		$53.80	$68.90	$140.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $10.58 / $20.05	Professional	26	$9.00	$10.58	$20.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.09 / $59.13 / $122.00	Professional	TC	$45.09	$59.13	$122.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.18 / $72.18 / $72.18	Professional		$72.18	$72.18	$72.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $14.17 / $15.26	Professional	26	$7.52	$14.17	$15.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $41.31 / $41.31	Professional	TC	$41.31	$41.31	$41.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.84 / $22.33 / $65.92	Professional		$7.84	$22.33	$65.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $5.04 / $19.00	Professional	26	$5.04	$5.04	$19.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.80 / $17.60 / $56.65	Professional	TC	$2.80	$17.60	$56.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.25 / $80.59 / $99.06	Facility		$13.25	$80.59	$99.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.54 / $70.76 / $99.06	Professional		$12.54	$70.76	$99.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.22 / $132.22 / $132.22	Facility		$132.22	$132.22	$132.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.26 / $20.26 / $20.26	Facility	26	$20.26	$20.26	$20.26
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $111.96 / $111.96 / $111.96	Facility	TC	$111.96	$111.96	$111.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.63 / $58.07 / $112.89	Professional		$36.63	$58.07	$112.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $14.72 / $27.48	Professional	26	$5.58	$14.72	$27.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $43.48 / $94.89	Professional	TC	$31.11	$43.48	$94.89
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 $49.98 / $68.87 / $115.85	Professional		$49.98	$68.87	$115.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $12.63 / $19.39	Professional	26	$8.86	$12.63	$19.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $58.14 / $111.77	Professional	TC	$37.54	$58.14	$111.77