Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.14 / $203.58 / $545.82	Facility		$117.14	$203.58	$545.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.17 / $55.40 / $118.79	Facility	26	$52.17	$55.40	$118.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.14 / $134.71 / $286.04	Professional		$117.14	$134.71	$286.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $62.97 / $106.28	Professional	26	$52.17	$62.97	$106.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $71.73 / $135.29	Professional	TC	$61.86	$71.73	$135.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.47 / $104.47 / $154.44	Professional		$104.47	$104.47	$154.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.73 / $81.72 / $113.13	Professional	26	$31.73	$81.72	$113.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.11 / $61.11 / $61.11	Professional	TC	$61.11	$61.11	$61.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.04 / $63.22 / $169.18	Professional		$43.04	$63.22	$169.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.95 / $29.95 / $98.90	Professional	26	$29.95	$29.95	$98.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.13 / $14.20 / $46.53	Professional	TC	$11.13	$14.20	$46.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.33 / $123.97 / $211.97	Facility		$76.33	$123.97	$211.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $115.12 / $211.97	Professional		$72.29	$115.12	$211.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $228.07 / $228.07 / $228.07	Facility		$228.07	$228.07	$228.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.28 / $115.28 / $115.28	Facility	26	$115.28	$115.28	$115.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $143.44 / $239.99	Professional		$73.81	$143.44	$239.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.93 / $84.53 / $148.13	Professional	26	$31.93	$84.53	$148.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.76 / $54.12 / $140.36	Professional	TC	$37.76	$54.12	$140.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $143.75 / $236.03	Professional		$89.13	$143.75	$236.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.22 / $73.43 / $113.63	Professional	26	$52.22	$73.43	$113.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.55 / $72.81 / $125.06	Professional	TC	$43.55	$72.81	$125.06