Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $512.86 / $933.25	Facility		$117.49	$512.86	$933.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $42.66 / $70.79	Facility	26	$27.54	$42.66	$70.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $47.86 / $75.86 / $104.71	Facility	TC	$47.86	$75.86	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $446.68	Professional		$72.44	$97.72	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $52.48 / $213.80	Professional	26	$25.70	$52.48	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $64.57 / $512.86	Professional	TC	$46.77	$64.57	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $100.00	Professional		$51.29	$51.29	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $31.62 / $43.65	Professional	26	$15.85	$31.62	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	TC	$35.48	$35.48	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $100.00	Professional		$45.71	$45.71	$100.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $54.95	Professional	26	$16.22	$16.22	$54.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $29.51 / $58.88	Professional	TC	$29.51	$29.51	$58.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $93.33 / $141.25	Facility		$42.66	$93.33	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $74.13 / $131.83	Professional		$38.02	$74.13	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $120.23 / $177.83	Facility		$53.70	$120.23	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $50.12 / $70.79	Facility	26	$10.72	$50.12	$70.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $85.11 / $123.03	Facility	TC	$18.20	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $104.71 / $524.81	Professional		$50.12	$104.71	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $50.12 / $213.80	Professional	26	$15.85	$50.12	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $53.70 / $371.54	Professional	TC	$31.62	$53.70	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $52.48 / $87.10	Facility		$34.67	$52.48	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $190.55	Professional		$70.79	$97.72	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $40.74 / $69.18	Professional	26	$31.62	$40.74	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $61.66 / $123.03	Professional	TC	$36.31	$61.66	$123.03