Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $389.05 / $1,000.00	Facility		$95.50	$389.05	$1,000.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $28.18 / $47.86	Facility	26	$25.70	$28.18	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $457.09	Professional		$72.44	$120.23	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.11 / $67.61	Professional	26	$22.91	$33.11	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $81.28 / $165.96	Professional	TC	$50.12	$81.28	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $165.96	Professional		$74.13	$91.20	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $27.54 / $50.12	Professional	26	$19.95	$27.54	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $66.07 / $120.23	Professional		$64.57	$66.07	$120.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.84 / $40.74	Professional	26	$26.92	$28.84	$40.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $38.02 / $77.62	Professional	TC	$36.31	$38.02	$77.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $100.00 / $144.54	Facility		$25.70	$100.00	$144.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $79.43 / $128.82	Professional		$26.30	$79.43	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $107.15 / $177.83	Facility		$38.90	$107.15	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.46 / $30.20 / $42.66	Facility	26	$6.46	$30.20	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $131.83 / $537.03	Professional		$74.13	$131.83	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $44.67 / $123.03	Professional	26	$25.12	$44.67	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $89.13 / $407.38	Professional	TC	$46.77	$89.13	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $141.25	Professional		$63.10	$87.10	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $27.54 / $40.74	Professional	26	$22.91	$27.54	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $63.10 / $107.15	Professional	TC	$38.90	$63.10	$107.15