Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $467.74 / $3,715.35	Facility		$338.84	$467.74	$3,715.35
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $138.04	Facility	26	$100.00	$100.00	$138.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $239.88 / $245.47 / $245.47	Facility	TC	$239.88	$245.47	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $812.83	Professional		$208.93	$309.03	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $218.78 / $691.83	Professional	26	$74.13	$218.78	$691.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $199.53 / $562.34	Professional	TC	$134.90	$199.53	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $257.04	Professional		$128.82	$173.78	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $75.86 / $102.33	Professional	26	$37.15	$75.86	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $251.19	Professional		$107.15	$134.90	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $91.20 / $114.82	Professional	26	$85.11	$91.20	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $43.65 / $109.65	Professional	TC	$22.91	$43.65	$109.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $245.47 / $363.08	Facility		$100.00	$245.47	$363.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $194.98 / $338.84	Professional		$89.13	$194.98	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $100.00 / $141.25	Facility	26	$21.38	$100.00	$141.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $51.29 / $239.88 / $346.74	Facility	TC	$51.29	$239.88	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $1,348.96	Professional		$128.82	$218.78	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $97.72 / $407.38	Professional	26	$37.15	$97.72	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $147.91 / $977.24	Professional	TC	$89.13	$147.91	$977.24
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 Facility Modifier Low / Median / High Price $87.10 / $128.82 / $213.80	Facility		$87.10	$128.82	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $251.19 / $457.09	Professional		$158.49	$251.19	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $85.11 / $162.18	Professional	26	$60.26	$85.11	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $169.82 / $295.12	Professional	TC	$83.18	$169.82	$295.12