Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.81 / $314.36 / $813.00	Facility		$89.81	$314.36	$813.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.17 / $32.74 / $91.15	Facility	26	$31.17	$32.74	$91.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.39 / $121.56 / $200.05	Professional		$88.39	$121.56	$200.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.16 / $44.43 / $64.43	Professional	26	$31.16	$44.43	$64.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.99 / $68.34 / $137.05	Professional	TC	$53.99	$68.34	$137.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.99 / $72.23 / $106.77	Professional		$63.99	$72.23	$106.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $28.08 / $67.20	Professional	26	$18.89	$28.08	$67.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.40 / $46.40 / $46.40	Professional	TC	$46.40	$46.40	$46.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.52 / $54.58 / $149.78	Professional		$50.52	$54.58	$149.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $78.94	Professional	26	$20.42	$20.42	$78.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.10 / $35.86 / $67.70	Professional	TC	$30.10	$35.86	$67.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.42 / $94.14 / $146.55	Facility		$45.42	$94.14	$146.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $84.05 / $146.55	Professional		$43.46	$84.05	$146.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.62 / $209.62 / $209.62	Facility		$209.62	$209.62	$209.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.87 / $90.87 / $90.87	Facility	26	$90.87	$90.87	$90.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.02 / $114.57 / $190.73	Professional		$54.02	$114.57	$190.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.98 / $58.40 / $95.41	Professional	26	$18.98	$58.40	$95.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.03 / $47.60 / $117.06	Professional	TC	$35.03	$47.60	$117.06
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 $85.60 / $118.63 / $228.04	Professional		$85.60	$118.63	$228.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $50.74 / $83.82	Professional	26	$38.95	$50.74	$83.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.73 / $72.84 / $125.05	Professional	TC	$41.73	$72.84	$125.05