Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.57 / $147.66 / $2,394.77	Facility		$126.57	$147.66	$2,394.77
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.45 / $71.63 / $83.37	Facility	26	$71.45	$71.63	$83.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.03 / $211.53 / $393.30	Professional		$135.03	$211.53	$393.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.68 / $75.90 / $146.05	Professional	26	$50.68	$75.90	$146.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.29 / $70.31 / $108.32	Professional	52	$63.29	$70.31	$108.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.06 / $116.53 / $295.47	Professional	TC	$61.06	$116.53	$295.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.56 / $106.56 / $113.99	Professional		$106.56	$106.56	$113.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $65.84 / $98.63	Professional	26	$64.58	$65.84	$98.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $213.57 / $707.57	Professional		$160.00	$213.57	$707.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.84 / $63.54 / $99.35	Professional	26	$52.84	$63.54	$99.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.48 / $132.97 / $670.81	Professional	TC	$94.48	$132.97	$670.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $103.18 / $193.14	Facility		$63.06	$103.18	$193.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.12 / $94.84 / $186.48	Professional		$65.12	$94.84	$186.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.76 / $167.76 / $5,718.65	Facility		$167.76	$167.76	$5,718.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $94.06	Facility	26	$94.06	$94.06	$94.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $341.35 / $804.99	Professional		$152.97	$341.35	$804.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.03 / $91.44 / $163.53	Professional	26	$62.03	$91.44	$163.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.48 / $247.25 / $714.03	Professional	TC	$73.48	$247.25	$714.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $353.96	Professional		$32.34	$32.34	$353.96
United Facility/Professional Professional Modifier Low / Median / High Price $147.26 / $215.63 / $493.62	Professional		$147.26	$215.63	$493.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $80.22 / $127.25	Professional	26	$54.82	$80.22	$127.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.44 / $103.12 / $423.12	Professional	TC	$68.44	$103.12	$423.12