Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.89 / $64.59 / $249.94	Facility		$50.89	$64.59	$249.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.71 / $28.83 / $28.83	Facility	26	$22.71	$28.83	$28.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $63.58 / $127.52	Professional		$50.89	$63.58	$127.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $81.93 / $81.93 / $81.93	Professional	25	$81.93	$81.93	$81.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.42 / $27.04 / $52.73	Professional	26	$22.42	$27.04	$52.73
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.45 / $28.85 / $43.09	Professional	52	$25.45	$28.85	$43.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $35.77 / $75.54	Professional	TC	$28.17	$35.77	$75.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.33 / $57.35 / $77.88	Professional		$53.33	$57.35	$77.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.61 / $63.08 / $83.64	Professional		$53.61	$63.08	$83.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $26.74 / $38.18	Professional	26	$21.12	$26.74	$38.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.65 / $36.34 / $46.30	Professional	TC	$29.65	$36.34	$46.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.98 / $38.47 / $77.88	Facility		$24.98	$38.47	$77.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.41 / $34.42 / $70.25	Professional		$24.41	$34.42	$70.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.84 / $70.84 / $70.84	Facility		$70.84	$70.84	$70.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.14 / $30.14 / $30.14	Facility	26	$30.14	$30.14	$30.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.44 / $79.33 / $130.19	Professional		$49.44	$79.33	$130.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.40 / $29.62 / $44.21	Professional	26	$21.40	$29.62	$44.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.11 / $44.52 / $78.19	Professional	TC	$28.11	$44.52	$78.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.12 / $32.34 / $35.15	Professional		$20.12	$32.34	$35.15
United Facility/Professional Professional Modifier Low / Median / High Price $49.10 / $62.13 / $94.45	Professional		$49.10	$62.13	$94.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $24.83 / $43.93	Professional	26	$20.73	$24.83	$43.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $36.65 / $62.83	Professional	TC	$27.55	$36.65	$62.83