Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.97 / $593.27 / $1,900.76	Facility		$61.97	$593.27	$1,900.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.07 / $21.07 / $34.44	Facility	26	$21.07	$21.07	$34.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.90 / $40.90 / $66.84	Facility	TC	$40.90	$40.90	$66.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $67.34 / $122.75	Professional		$59.78	$67.34	$122.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $21.87 / $64.34	Professional	26	$18.78	$21.87	$64.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.90 / $45.22 / $119.92	Professional	TC	$40.90	$45.22	$119.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $84.22 / $85.91	Professional		$51.77	$84.22	$85.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $26.01 / $35.70	Professional	26	$14.93	$26.01	$35.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.52 / $40.52 / $40.52	Professional	TC	$40.52	$40.52	$40.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $37.09 / $60.29	Professional		$37.09	$37.09	$60.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $11.17 / $11.95	Professional	26	$11.17	$11.17	$11.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.92 / $25.92 / $48.56	Professional	TC	$25.92	$25.92	$48.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.98 / $82.21 / $117.91	Facility		$30.98	$82.21	$117.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.35 / $73.40 / $117.91	Professional		$30.35	$73.40	$117.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.16 / $176.16 / $176.16	Facility		$176.16	$176.16	$176.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $71.22 / $71.22	Facility	26	$71.22	$71.22	$71.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $104.94 / $104.94 / $104.94	Facility	TC	$104.94	$104.94	$104.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.91 / $60.81 / $133.49	Professional		$31.91	$60.81	$133.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $20.91 / $40.42	Professional	26	$11.04	$20.91	$40.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $40.74 / $93.31	Professional	TC	$21.26	$40.74	$93.31
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 $52.44 / $83.42 / $135.93	Professional		$52.44	$83.42	$135.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $28.39 / $44.39	Professional	26	$17.14	$28.39	$44.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.01 / $56.46 / $90.45	Professional	TC	$35.01	$56.46	$90.45