Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.92 / $362.04 / $1,312.76	Facility		$52.92	$362.04	$1,312.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.55 / $29.87 / $53.25	Facility	26	$26.55	$29.87	$53.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.59 / $100.03 / $502.79	Professional		$50.59	$100.03	$502.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.05 / $30.84 / $120.83	Professional	26	$28.05	$30.84	$120.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $39.13 / $187.42	Professional	TC	$22.36	$39.13	$187.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.40 / $56.23 / $68.80	Professional		$43.40	$56.23	$68.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $30.16 / $36.70	Professional	26	$22.59	$30.16	$36.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $138.00 / $138.00	Facility		$138.00	$138.00	$138.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $76.83 / $173.44	Professional		$59.15	$76.83	$173.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $32.69 / $51.30	Professional	26	$26.84	$32.69	$51.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.88 / $37.42 / $120.21	Professional	TC	$30.88	$37.42	$120.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.68 / $39.50 / $74.09	Facility		$25.68	$39.50	$74.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $35.72 / $71.44	Professional		$27.16	$35.72	$71.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.84 / $65.84 / $85.16	Facility		$65.84	$65.84	$85.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.59 / $141.29 / $310.93	Professional		$53.59	$141.29	$310.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.76 / $44.55 / $76.64	Professional	26	$28.76	$44.55	$76.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $97.35 / $257.45	Professional	TC	$24.83	$97.35	$257.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $68.80	Professional		$32.34	$32.34	$68.80
United Facility/Professional Professional Modifier Low / Median / High Price $48.66 / $81.11 / $179.87	Professional		$48.66	$81.11	$179.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.24 / $35.51 / $48.72	Professional	26	$28.24	$35.51	$48.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $36.75 / $145.52	Professional	TC	$20.79	$36.75	$145.52