Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.70 / $195.69 / $858.52	Facility		$119.70	$195.69	$858.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.56 / $28.56 / $46.68	Facility	26	$28.56	$28.56	$46.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $122.52 / $151.53	Professional		$103.56	$122.52	$151.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $30.61 / $40.44	Professional	26	$27.91	$30.61	$40.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $94.61 / $115.37	Professional	TC	$68.95	$94.61	$115.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.75 / $152.75 / $152.75	Professional		$152.75	$152.75	$152.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $48.79 / $48.79	Professional	26	$24.04	$48.79	$48.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $71.43 / $94.10	Professional		$71.42	$71.43	$94.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.42 / $16.42 / $34.29	Professional	26	$16.42	$16.42	$34.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.01 / $55.01 / $59.81	Professional	TC	$55.01	$55.01	$59.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.31 / $155.85 / $209.65	Facility		$42.31	$155.85	$209.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $143.63 / $209.65	Professional		$40.47	$143.63	$209.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.48 / $528.48 / $528.48	Facility		$528.48	$528.48	$528.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $116.39 / $254.45	Professional		$55.32	$116.39	$254.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.69 / $35.57 / $70.90	Professional	26	$17.69	$35.57	$70.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.74 / $79.95 / $182.23	Professional	TC	$35.74	$79.95	$182.23
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 $96.88 / $156.76 / $251.13	Professional		$96.88	$156.76	$251.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.86 / $40.06 / $61.66	Professional	26	$23.86	$40.06	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.59 / $115.73 / $189.48	Professional	TC	$69.59	$115.73	$189.48