Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.93 / $470.25 / $1,101.23	Facility		$338.93	$470.25	$1,101.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.26 / $100.15 / $138.26	Facility	26	$61.26	$100.15	$138.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $146.07 / $238.78 / $550.62	Facility	TC	$146.07	$238.78	$550.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.27 / $225.62 / $484.79	Professional		$196.27	$225.62	$484.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.26 / $71.06 / $124.85	Professional	26	$61.26	$71.06	$124.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.18 / $152.24 / $286.83	Professional	TC	$131.18	$152.24	$286.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.76 / $172.76 / $255.38	Professional		$172.76	$172.76	$255.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.56 / $75.06 / $103.03	Professional	26	$44.56	$75.06	$103.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $121.98 / $121.98 / $121.98	Professional	TC	$121.98	$121.98	$121.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $134.52 / $254.10	Professional		$107.04	$134.52	$254.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.59 / $86.87 / $101.50	Professional	26	$73.59	$86.87	$101.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.70 / $43.55 / $140.24	Professional	TC	$22.70	$43.55	$140.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.44 / $247.49 / $350.52	Facility		$89.44	$247.49	$350.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.57 / $220.98 / $350.52	Professional		$87.57	$220.98	$350.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $486.49 / $486.49 / $486.49	Facility		$486.49	$486.49	$486.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.01 / $142.01 / $142.01	Facility	26	$142.01	$142.01	$142.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $344.47 / $344.47 / $344.47	Facility	TC	$344.47	$344.47	$344.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.63 / $209.26 / $396.84	Professional		$129.63	$209.26	$396.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.45 / $97.07 / $169.79	Professional	26	$37.45	$97.07	$169.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.52 / $108.08 / $280.19	Professional	TC	$88.52	$108.08	$280.19
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 $156.94 / $260.74 / $422.25	Professional		$156.94	$260.74	$422.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.41 / $84.25 / $132.77	Professional	26	$60.41	$84.25	$132.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.49 / $170.27 / $292.32	Professional	TC	$82.49	$170.27	$292.32