Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.80 / $389.02 / $963.68	Facility		$101.80	$389.02	$963.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.39 / $36.93 / $63.13	Facility	26	$32.39	$36.93	$63.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $65.95 / $97.82 / $343.41	Facility	TC	$65.95	$97.82	$343.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.89 / $119.64 / $202.00	Professional		$95.89	$119.64	$202.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $33.95 / $74.54	Professional	26	$31.67	$33.95	$74.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.24 / $50.48 / $62.08	Professional	52	$46.24	$50.48	$62.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.90 / $75.20 / $126.39	Professional	TC	$65.90	$75.20	$126.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $78.84 / $146.03	Professional		$66.20	$78.84	$146.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.74 / $27.94 / $48.48	Professional	26	$25.74	$27.94	$48.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.04 / $81.29 / $227.50	Professional	TC	$58.04	$81.29	$227.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.04 / $350.00 / $412.41	Facility		$123.04	$350.00	$412.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.49 / $130.02 / $190.71	Professional		$105.49	$130.02	$190.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.64 / $55.28 / $66.70	Professional	26	$38.64	$55.28	$66.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.26 / $74.73 / $115.84	Professional	TC	$67.26	$74.73	$115.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $78.04 / $131.41	Facility		$35.54	$78.04	$131.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $77.53 / $123.03	Professional		$34.58	$77.53	$123.03
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 $40.13 / $40.13 / $40.13	Facility	26	$40.13	$40.13	$40.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $82.40 / $82.40 / $82.40	Facility	TC	$82.40	$82.40	$82.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.99 / $143.55 / $246.72	Professional		$105.99	$143.55	$246.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $46.37 / $76.43	Professional	26	$33.44	$46.37	$76.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.95 / $97.55 / $169.36	Professional	TC	$71.95	$97.55	$169.36
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 $97.86 / $125.71 / $217.82	Professional		$97.86	$125.71	$217.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $37.93 / $65.89	Professional	26	$31.89	$37.93	$65.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.19 / $84.96 / $137.09	Professional	TC	$66.19	$84.96	$137.09