Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $257.04 / $281.84	Facility		$38.90	$257.04	$281.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $66.07 / $162.18	Professional		$37.15	$66.07	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $97.72	Professional	26	$25.12	$38.90	$97.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $72.44 / $269.15	Professional	50	$50.12	$72.44	$269.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.22 / $16.22 / $20.89	Professional	52	$16.22	$16.22	$20.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $23.99 / $89.13	Professional	TC	$12.88	$23.99	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $60.26	Professional		$39.81	$45.71	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.84 / $41.69	Professional	26	$25.70	$28.84	$41.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $16.22 / $21.88	Professional	TC	$13.80	$16.22	$21.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $407.38 / $549.54	Facility		$85.11	$407.38	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $134.90	Professional		$63.10	$87.10	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.20 / $46.77	Professional	26	$25.70	$30.20	$46.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $128.82 / $204.17	Professional	50	$95.50	$128.82	$204.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $56.23 / $85.11	Professional	TC	$30.20	$56.23	$85.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $35.48 / $60.26	Facility		$18.62	$35.48	$60.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $33.11 / $56.23	Professional		$16.60	$33.11	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $97.72 / $141.25	Facility		$70.79	$97.72	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $154.88	Professional		$43.65	$83.18	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $66.07	Professional	26	$23.99	$35.48	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $44.67 / $89.13	Professional	TC	$15.14	$44.67	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $70.79 / $234.42	Facility		$31.62	$70.79	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $112.20	Professional		$51.29	$77.62	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $31.62 / $43.65	Professional	26	$26.30	$31.62	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $43.65 / $70.79	Professional	TC	$22.39	$43.65	$70.79