Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.67 / $543.00 / $5,634.00	Facility		$179.67	$543.00	$5,634.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.35 / $37.35 / $60.70	Facility	26	$37.35	$37.35	$60.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $183.95 / $287.98	Professional		$140.13	$183.95	$287.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.35 / $41.96 / $82.63	Professional	26	$37.35	$41.96	$82.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $142.32 / $200.67	Professional	TC	$98.17	$142.32	$200.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.68 / $190.68 / $190.68	Professional		$190.68	$190.68	$190.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.88 / $53.88 / $53.88	Professional	26	$53.88	$53.88	$53.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.40 / $130.40 / $251.67	Facility		$130.40	$130.40	$251.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $146.83 / $232.72	Professional		$110.84	$146.83	$232.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.47 / $55.93 / $139.26	Professional	26	$33.47	$55.93	$139.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.16 / $24.90 / $94.13	Professional	TC	$21.16	$24.90	$94.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.10 / $142.04 / $201.89	Facility		$43.10	$142.04	$201.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $130.66 / $186.94	Professional		$37.72	$130.66	$186.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $247.78 / $527.30	Professional		$141.60	$247.78	$527.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.45 / $80.98 / $125.27	Professional	26	$41.45	$80.98	$125.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.29 / $167.88 / $322.10	Professional	TC	$100.29	$167.88	$322.10
United Facility/Professional Facility Modifier Low / Median / High Price $933.00 / $2,252.00 / $4,426.00	Facility		$933.00	$2,252.00	$4,426.00
United Facility/Professional Professional Modifier Low / Median / High Price $113.64 / $191.33 / $317.39	Professional		$113.64	$191.33	$317.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.01 / $54.19 / $88.90	Professional	26	$39.01	$54.19	$88.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.24 / $147.38 / $237.47	Professional	TC	$82.24	$147.38	$237.47