Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.16 / $324.14 / $945.75	Facility		$97.16	$324.14	$945.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.55 / $40.61 / $62.01	Facility	26	$30.55	$40.61	$62.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $62.14 / $104.53 / $449.55	Facility	TC	$62.14	$104.53	$449.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.92 / $133.18 / $546.00	Professional		$92.92	$133.18	$546.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $39.71 / $135.88	Professional	26	$31.67	$39.71	$135.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.97 / $49.96 / $62.77	Professional	52	$44.97	$49.96	$62.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.61 / $87.95 / $146.84	Professional	TC	$60.61	$87.95	$146.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $104.58 / $141.96	Professional		$73.92	$104.58	$141.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $30.68 / $41.43	Professional	26	$25.85	$30.68	$41.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.15 / $66.50 / $71.86	Professional	TC	$62.15	$66.50	$71.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.38 / $115.74 / $167.57	Professional		$98.38	$115.74	$167.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.01 / $40.02 / $56.83	Professional	26	$34.01	$40.02	$56.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.36 / $75.72 / $117.51	Professional	TC	$64.36	$75.72	$117.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.14 / $79.95 / $132.50	Facility		$33.14	$79.95	$132.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $71.47 / $132.50	Professional		$35.74	$71.47	$132.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.64 / $121.16 / $197.24	Facility		$116.64	$121.16	$197.24
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 $97.97 / $152.72 / $230.67	Professional		$97.97	$152.72	$230.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.18 / $48.74 / $81.69	Professional	26	$31.18	$48.74	$81.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.53 / $102.70 / $161.16	Professional	TC	$64.53	$102.70	$161.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $88.80	Professional		$32.34	$32.34	$88.80
United Facility/Professional Professional Modifier Low / Median / High Price $95.56 / $120.08 / $168.99	Professional		$95.56	$120.08	$168.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $39.14 / $54.67	Professional	26	$32.50	$39.14	$54.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.85 / $82.99 / $116.40	Professional	TC	$62.85	$82.99	$116.40