Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.45 / $447.85 / $1,298.30	Facility		$101.45	$447.85	$1,298.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.49 / $37.53 / $67.39	Facility	26	$33.49	$37.53	$67.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.08 / $136.33 / $558.00	Professional		$101.08	$136.33	$558.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $41.78 / $148.80	Professional	26	$34.67	$41.78	$148.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.68 / $87.95 / $159.82	Professional	TC	$65.68	$87.95	$159.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $129.35 / $152.18	Professional		$79.26	$129.35	$152.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.38 / $35.47 / $49.85	Professional	26	$28.38	$35.47	$49.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.96 / $65.84 / $70.45	Professional	TC	$55.96	$65.84	$70.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.99 / $119.55 / $178.00	Professional		$104.99	$119.55	$178.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.25 / $43.83 / $66.08	Professional	26	$37.25	$43.83	$66.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.09 / $75.72 / $123.16	Professional	TC	$68.09	$75.72	$123.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.32 / $82.30 / $142.03	Facility		$36.32	$82.30	$142.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.17 / $75.72 / $142.03	Professional		$39.17	$75.72	$142.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.64 / $130.11 / $197.24	Facility		$116.64	$130.11	$197.24
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 $106.83 / $160.03 / $260.19	Professional		$106.83	$160.03	$260.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.35 / $54.42 / $89.52	Professional	26	$36.35	$54.42	$89.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.55 / $107.56 / $170.67	Professional	TC	$71.55	$107.56	$170.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $91.78	Professional		$32.34	$32.34	$91.78
United Facility/Professional Professional Modifier Low / Median / High Price $102.12 / $126.55 / $187.85	Professional		$102.12	$126.55	$187.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $42.04 / $62.79	Professional	26	$36.15	$42.04	$62.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.69 / $87.54 / $120.29	Professional	TC	$66.69	$87.54	$120.29