Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.80 / $175.07 / $723.65	Facility		$84.80	$175.07	$723.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.52 / $20.37 / $28.34	Facility	26	$13.52	$20.37	$28.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $95.67 / $173.18	Professional		$81.59	$95.67	$173.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $15.03 / $37.72	Professional	26	$14.19	$15.03	$37.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $79.58 / $149.21	Professional	TC	$67.40	$79.58	$149.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.53 / $17.96 / $17.96	Professional	26	$11.53	$17.96	$17.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.65 / $77.23 / $133.59	Professional		$65.65	$77.23	$133.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.13 / $17.87 / $27.49	Professional	26	$15.13	$17.87	$27.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.50 / $59.42 / $108.11	Professional	TC	$50.50	$59.42	$108.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.48 / $90.22 / $123.47	Facility		$16.48	$90.22	$123.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.53 / $22.99 / $132.65	Professional		$16.53	$22.99	$132.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.32 / $116.32 / $439.62	Facility		$116.32	$116.32	$439.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.87 / $111.01 / $193.00	Professional		$79.87	$111.01	$193.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $23.32 / $35.43	Professional	26	$15.58	$23.32	$35.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.92 / $95.43 / $156.94	Professional	TC	$67.92	$95.43	$156.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $59.13	Professional		$32.34	$32.34	$59.13
United Facility/Professional Facility Modifier Low / Median / High Price $132.53 / $132.53 / $178.54	Facility		$132.53	$132.53	$178.54
United Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $93.82 / $138.44	Professional		$73.92	$93.82	$138.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $18.26 / $24.62	Professional	26	$14.44	$18.26	$24.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.26 / $77.38 / $110.73	Professional	TC	$58.26	$77.38	$110.73