Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.52 / $1,631.62 / $3,029.38	Facility		$310.52	$1,631.62	$3,029.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.43 / $86.23 / $97.68	Facility	26	$74.43	$86.23	$97.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.13 / $233.85 / $448.81	Professional		$184.13	$233.85	$448.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.86 / $77.45 / $140.00	Professional	26	$63.86	$77.45	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.48 / $149.61 / $218.83	Professional	TC	$124.48	$149.61	$218.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.66 / $175.97 / $263.95	Professional		$119.66	$175.97	$263.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.69 / $76.03 / $95.04	Professional	26	$50.69	$76.03	$95.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.72 / $168.92 / $168.92	Professional	TC	$95.72	$168.92	$168.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $365.44 / $2,048.00 / $3,685.00	Facility		$365.44	$2,048.00	$3,685.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.14 / $310.62 / $493.34	Professional		$196.14	$310.62	$493.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.40 / $89.54 / $139.33	Professional	26	$68.40	$89.54	$139.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.75 / $222.89 / $353.27	Professional	TC	$127.75	$222.89	$353.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.79 / $135.13 / $237.56	Facility		$69.79	$135.13	$237.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $134.44 / $221.92	Professional		$67.31	$134.44	$221.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $219.59 / $219.59	Facility		$219.59	$219.59	$219.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.57 / $303.85 / $451.81	Professional		$192.57	$303.85	$451.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.73 / $91.73 / $131.41	Professional	26	$70.73	$91.73	$131.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.09 / $209.29 / $299.18	Professional	TC	$130.09	$209.29	$299.18
United Facility/Professional Professional Modifier Low / Median / High Price $182.30 / $253.32 / $427.39	Professional		$182.30	$253.32	$427.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.64 / $79.48 / $151.11	Professional	26	$62.64	$79.48	$151.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.09 / $178.36 / $308.23	Professional	TC	$122.09	$178.36	$308.23