Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $156.66 / $240.90	Facility		$74.86	$156.66	$240.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.11 / $75.37 / $103.69	Facility	26	$46.11	$75.37	$103.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.75 / $46.99 / $52.99	Facility	TC	$28.75	$46.99	$52.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.86 / $88.26 / $165.44	Professional		$74.86	$88.26	$165.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.11 / $55.28 / $95.01	Professional	26	$46.11	$55.28	$95.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.42 / $32.97 / $62.20	Professional	TC	$28.42	$32.97	$62.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $62.40 / $92.25	Professional		$62.40	$62.40	$92.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.20 / $56.94 / $78.15	Professional	26	$28.20	$56.94	$78.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $23.89 / $23.89	Professional	TC	$23.89	$23.89	$23.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $40.11 / $115.42	Professional		$39.89	$40.11	$115.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $26.64 / $85.37	Professional	26	$26.64	$26.64	$85.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.48 / $16.23 / $33.74	Professional	TC	$13.48	$16.23	$33.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.19 / $78.15 / $126.62	Facility		$43.19	$78.15	$126.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $69.78 / $126.62	Professional		$39.86	$69.78	$126.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $139.63	Facility		$139.63	$139.63	$139.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $91.98 / $91.98	Facility	26	$91.98	$91.98	$91.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.65 / $47.65 / $47.65	Facility	TC	$47.65	$47.65	$47.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.47 / $96.14 / $153.24	Professional		$46.47	$96.14	$153.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.40 / $72.50 / $127.14	Professional	26	$28.40	$72.50	$127.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $23.64 / $56.86	Professional	TC	$18.00	$23.64	$56.86
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 $57.68 / $95.60 / $150.50	Professional		$57.68	$95.60	$150.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.51 / $64.34 / $123.69	Professional	26	$45.51	$64.34	$123.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.84 / $60.53	Professional	TC	$20.42	$29.84	$60.53