Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.32 / $519.37 / $999.48	Facility		$95.32	$519.37	$999.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.73 / $26.73 / $47.10	Facility	26	$23.73	$26.73	$47.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.84 / $125.31 / $468.15	Professional		$93.84	$125.31	$468.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $33.70 / $103.34	Professional	26	$24.07	$33.70	$103.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.68 / $50.76 / $52.19	Professional	52	$45.68	$50.76	$52.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.63 / $83.28 / $155.47	Professional	TC	$67.63	$83.28	$155.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $121.55 / $143.00	Professional		$78.81	$121.55	$143.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $24.85 / $32.45	Professional	26	$19.88	$24.85	$32.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.38 / $75.31 / $91.49	Professional	TC	$70.38	$75.31	$91.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $138.00 / $138.00	Facility		$138.00	$138.00	$138.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $97.22 / $153.03	Professional		$82.63	$97.22	$153.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $28.16 / $43.23	Professional	26	$22.13	$28.16	$43.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.50 / $73.68 / $112.11	Professional	TC	$55.50	$73.68	$112.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.30 / $86.33 / $133.72	Facility		$25.30	$86.33	$133.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.34 / $80.94 / $133.46	Professional		$27.34	$80.94	$133.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.64 / $123.40 / $197.24	Facility		$116.64	$123.40	$197.24
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 $85.16 / $131.30 / $232.59	Professional		$85.16	$131.30	$232.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $36.92 / $63.31	Professional	26	$25.11	$36.92	$63.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.21 / $96.24 / $182.81	Professional	TC	$59.21	$96.24	$182.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $65.28	Professional		$32.34	$32.34	$65.28
United Facility/Professional Facility Modifier Low / Median / High Price $143.63 / $143.63 / $143.63	Facility		$143.63	$143.63	$143.63
United Facility/Professional Professional Modifier Low / Median / High Price $85.13 / $109.20 / $158.43	Professional		$85.13	$109.20	$158.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.96 / $29.31 / $41.60	Professional	26	$24.96	$29.31	$41.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.77 / $83.03 / $116.83	Professional	TC	$59.77	$83.03	$116.83