Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.10 / $787.00 / $8,229.00	Facility		$292.10	$787.00	$8,229.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.04 / $124.74 / $153.52	Facility	26	$124.04	$124.74	$153.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.64 / $407.33 / $603.15	Professional		$346.64	$407.33	$603.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.31 / $128.53 / $187.10	Professional	26	$124.31	$128.53	$187.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.38 / $261.14 / $343.02	Professional	TC	$219.38	$261.14	$343.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $375.55 / $375.55 / $375.55	Professional		$375.55	$375.55	$375.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $1,991.00 / $2,894.00	Facility		$1,041.00	$1,991.00	$2,894.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.93 / $329.52 / $472.71	Professional		$271.93	$329.52	$472.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $111.49 / $135.10 / $173.18	Professional	26	$111.49	$135.10	$173.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.43 / $194.42 / $306.93	Professional	TC	$160.43	$194.42	$306.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.57 / $279.24 / $457.61	Facility		$162.57	$279.24	$457.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $133.54 / $229.38 / $448.79	Professional		$133.54	$229.38	$448.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $429.12 / $429.12 / $429.12	Facility		$429.12	$429.12	$429.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.32 / $142.32 / $142.32	Facility	26	$142.32	$142.32	$142.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.70 / $443.60 / $701.08	Professional		$321.70	$443.60	$701.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.28 / $179.43 / $274.51	Professional	26	$123.28	$179.43	$274.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.15 / $266.79 / $433.28	Professional	TC	$188.15	$266.79	$433.28
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 Facility Modifier Low / Median / High Price $391.00 / $950.00 / $3,394.00	Facility		$391.00	$950.00	$3,394.00
United Facility/Professional Professional Modifier Low / Median / High Price $319.62 / $449.27 / $711.67	Professional		$319.62	$449.27	$711.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.16 / $186.39 / $265.31	Professional	26	$127.16	$186.39	$265.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.99 / $254.54 / $437.72	Professional	TC	$198.99	$254.54	$437.72