Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.74 / $540.08 / $889.48	Facility		$105.74	$540.08	$889.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.03 / $31.24 / $708.30	Facility	26	$26.03	$31.24	$708.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.50 / $76.87 / $336.94	Facility	TC	$53.50	$76.87	$336.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $96.70 / $167.00	Professional		$78.00	$96.70	$167.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $32.53 / $61.86	Professional	26	$25.26	$32.53	$61.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.60 / $60.80 / $102.30	Professional	TC	$50.60	$60.80	$102.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $62.77 / $112.99	Professional		$53.36	$62.77	$112.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.56 / $22.28 / $38.72	Professional	26	$20.56	$22.28	$38.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $71.08 / $227.50	Professional	TC	$32.22	$71.08	$227.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.97 / $299.02 / $350.00	Facility		$93.97	$299.02	$350.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.80 / $99.83 / $143.97	Professional		$80.80	$99.83	$143.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.64 / $42.13 / $53.60	Professional	26	$30.64	$42.13	$53.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.77 / $55.67 / $86.28	Professional	TC	$51.77	$55.67	$86.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.53 / $63.18 / $105.92	Facility		$28.53	$63.18	$105.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $60.81 / $99.00	Professional		$27.43	$60.81	$99.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.31 / $350.00 / $350.00	Facility		$97.31	$350.00	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.90 / $113.16 / $187.58	Professional		$84.90	$113.16	$187.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.39 / $37.26 / $61.44	Professional	26	$26.39	$37.26	$61.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.63 / $76.56 / $126.14	Professional	TC	$54.63	$76.56	$126.14
United Facility/Professional Facility Modifier Low / Median / High Price $235.69 / $235.69 / $235.69	Facility		$235.69	$235.69	$235.69
United Facility/Professional Professional Modifier Low / Median / High Price $80.69 / $96.05 / $161.75	Professional		$80.69	$96.05	$161.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.46 / $30.67 / $53.60	Professional	26	$25.46	$30.67	$53.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.58 / $65.95 / $108.22	Professional	TC	$52.58	$65.95	$108.22