Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $524.81 / $912.01	Facility		$112.20	$524.81	$912.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $43.65 / $61.66	Facility	26	$32.36	$43.65	$61.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $66.07 / $100.00 / $229.09	Facility	TC	$66.07	$100.00	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $147.91 / $398.11	Professional		$91.20	$147.91	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $47.86 / $114.82	Professional	26	$31.62	$47.86	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $87.10 / $169.82	Professional	TC	$61.66	$87.10	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $104.71	Professional		$70.79	$81.28	$104.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.84 / $48.98	Professional	26	$25.70	$28.84	$48.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $100.00	Professional	TC	$47.86	$61.66	$100.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $295.12 / $346.74	Facility		$117.49	$295.12	$346.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $199.53	Professional		$112.20	$128.82	$199.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $54.95 / $77.62	Professional	26	$38.02	$54.95	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $74.13 / $125.89	Professional	TC	$70.79	$74.13	$125.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $81.28 / $131.83	Facility		$39.81	$81.28	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $77.62 / $125.89	Professional		$35.48	$77.62	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $162.18 / $281.84	Facility		$131.83	$162.18	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $144.54 / $245.47	Professional		$95.50	$144.54	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $45.71 / $75.86	Professional	26	$28.84	$45.71	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $97.72 / $169.82	Professional	TC	$64.57	$97.72	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $89.13 / $138.04	Facility		$81.28	$89.13	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $190.55	Professional		$97.72	$123.03	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.90 / $60.26	Professional	26	$30.90	$38.90	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $85.11 / $134.90	Professional	TC	$66.07	$85.11	$134.90