Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.78 / $1,476.22 / $3,515.60	Facility		$187.78	$1,476.22	$3,515.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $80.86 / $135.97	Facility	26	$68.70	$80.86	$135.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.01 / $259.52 / $926.00	Professional		$194.01	$259.52	$926.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.95 / $80.86 / $267.00	Professional	26	$63.95	$80.86	$267.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.00 / $175.12 / $330.31	Professional	TC	$123.00	$175.12	$330.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.71 / $217.66 / $221.92	Professional		$170.71	$217.66	$221.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.16 / $78.95 / $88.42	Professional	26	$63.16	$78.95	$88.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,614.00 / $2,894.00 / $5,202.00	Facility		$1,614.00	$2,894.00	$5,202.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.71 / $224.69 / $361.66	Professional		$166.71	$224.69	$361.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.14 / $69.09 / $103.21	Professional	26	$58.14	$69.09	$103.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.58 / $152.09 / $256.57	Professional	TC	$108.58	$152.09	$256.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.89 / $134.44 / $238.99	Facility		$63.89	$134.44	$238.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $123.68 / $237.18	Professional		$69.48	$123.68	$237.18
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 $185.72 / $306.98 / $474.83	Professional		$185.72	$306.98	$474.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $96.97 / $140.46	Professional	26	$66.81	$96.97	$140.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.66 / $217.16 / $333.85	Professional	TC	$125.66	$217.16	$333.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $221.92	Professional		$32.34	$32.34	$221.92
United Facility/Professional Professional Modifier Low / Median / High Price $193.44 / $291.95 / $381.02	Professional		$193.44	$291.95	$381.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $92.60 / $133.76	Professional	26	$67.98	$92.60	$133.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.33 / $200.60 / $274.73	Professional	TC	$124.33	$200.60	$274.73