Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.66 / $350.00 / $1,093.16	Facility		$105.66	$350.00	$1,093.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.56 / $42.67 / $68.75	Facility	26	$35.56	$42.67	$68.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $122.62 / $207.24	Professional		$104.34	$122.62	$207.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $37.17 / $79.95	Professional	26	$34.67	$37.17	$79.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.20 / $79.67 / $121.80	Professional	TC	$67.20	$79.67	$121.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.86 / $83.52 / $152.18	Professional		$81.86	$83.52	$152.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $30.87 / $54.39	Professional	26	$28.25	$30.87	$54.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.61 / $74.47 / $227.50	Professional	TC	$53.61	$74.47	$227.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.48 / $350.00 / $439.05	Facility		$127.48	$350.00	$439.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $141.28 / $197.59	Professional		$113.02	$141.28	$197.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.35 / $61.90 / $73.23	Professional	26	$42.35	$61.90	$73.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.91 / $75.08 / $116.37	Professional	TC	$68.91	$75.08	$116.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.03 / $82.69 / $140.91	Facility		$39.03	$82.69	$140.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $82.30 / $131.88	Professional		$37.25	$82.30	$131.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.40 / $350.00 / $350.00	Facility		$111.40	$350.00	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.01 / $153.54 / $254.57	Professional		$116.01	$153.54	$254.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $50.90 / $84.31	Professional	26	$37.26	$50.90	$84.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.88 / $102.22 / $170.14	Professional	TC	$74.88	$102.22	$170.14
United Facility/Professional Professional Modifier Low / Median / High Price $106.45 / $128.29 / $216.00	Professional		$106.45	$128.29	$216.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.59 / $42.26 / $72.33	Professional	26	$35.59	$42.26	$72.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.86 / $87.54 / $143.79	Professional	TC	$70.86	$87.54	$143.79