Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.23 / $490.01 / $989.96	Facility		$80.23	$490.01	$989.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.65 / $27.75 / $48.93	Facility	26	$24.65	$27.75	$48.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $52.49 / $233.47 / $465.35	Facility	TC	$52.49	$233.47	$465.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.70 / $107.68 / $491.00	Professional		$78.70	$107.68	$491.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $36.61 / $116.00	Professional	26	$25.26	$36.61	$116.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.43 / $68.20 / $117.26	Professional	TC	$49.43	$68.20	$117.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.77 / $84.57 / $114.23	Professional		$62.77	$84.57	$114.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.65 / $25.82 / $33.71	Professional	26	$20.65	$25.82	$33.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.69 / $55.49 / $75.33	Professional	TC	$42.69	$55.49	$75.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.36 / $94.55 / $136.72	Professional		$80.36	$94.55	$136.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.24 / $32.04 / $45.46	Professional	26	$27.24	$32.04	$45.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.77 / $60.67 / $95.06	Professional	TC	$51.77	$60.67	$95.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.28 / $62.78 / $106.61	Facility		$26.28	$62.78	$106.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $57.75 / $106.61	Professional		$28.52	$57.75	$106.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.31 / $97.31 / $197.24	Facility		$97.31	$97.31	$197.24
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 $78.66 / $121.03 / $182.80	Professional		$78.66	$121.03	$182.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $39.25 / $65.92	Professional	26	$24.89	$39.25	$65.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.27 / $79.34 / $131.01	Professional	TC	$52.27	$79.34	$131.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $66.47	Professional		$32.34	$32.34	$66.47
United Facility/Professional Professional Modifier Low / Median / High Price $75.30 / $97.40 / $139.13	Professional		$75.30	$97.40	$139.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.93 / $30.85 / $44.93	Professional	26	$25.93	$30.85	$44.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.51 / $65.83 / $87.92	Professional	TC	$50.51	$65.83	$87.92