Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.80 / $394.63 / $890.97	Facility		$101.80	$394.63	$890.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.05 / $30.07 / $52.20	Facility	26	$25.05	$30.07	$52.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.80 / $119.81 / $213.00	Professional		$95.80	$119.81	$213.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $26.46 / $57.64	Professional	26	$24.07	$26.46	$57.64
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $47.10 / $51.10 / $63.23	Professional	52	$47.10	$51.10	$63.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.76 / $80.30 / $143.18	Professional	TC	$70.76	$80.30	$143.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $78.81 / $147.80	Professional		$67.00	$78.81	$147.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $21.72 / $37.28	Professional	26	$19.82	$21.72	$37.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.10 / $64.43 / $110.52	Professional	TC	$50.10	$64.43	$110.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $350.00 / $420.16	Facility		$108.60	$350.00	$420.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $108.60 / $157.04	Professional		$86.88	$108.60	$157.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $42.48 / $58.62	Professional	26	$22.13	$42.48	$58.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.50 / $66.11 / $101.01	Professional	TC	$55.50	$66.11	$101.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.34 / $88.42 / $133.02	Facility		$27.34	$88.42	$133.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $84.73 / $123.93	Professional		$26.40	$84.73	$123.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.40 / $350.00 / $350.00	Facility		$123.40	$350.00	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $30.47 / $30.47	Facility	26	$30.47	$30.47	$30.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.40 / $125.89 / $231.92	Professional		$91.40	$125.89	$231.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.39 / $35.86 / $57.71	Professional	26	$25.39	$35.86	$57.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.27 / $89.99 / $172.90	Professional	TC	$61.27	$89.99	$172.90
United Facility/Professional Facility Modifier Low / Median / High Price $34.07 / $137.86 / $235.69	Facility		$34.07	$137.86	$235.69
United Facility/Professional Professional Modifier Low / Median / High Price $93.34 / $116.87 / $188.82	Professional		$93.34	$116.87	$188.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.44 / $28.90 / $50.96	Professional	26	$24.44	$28.90	$50.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.80 / $87.32 / $142.62	Professional	TC	$68.80	$87.32	$142.62