Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.53 / $350.00 / $1,515.11	Facility		$117.53	$350.00	$1,515.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.03 / $23.64 / $24.03	Facility	26	$20.03	$23.64	$24.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.53 / $142.69 / $220.96	Professional		$117.53	$142.69	$220.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.94 / $21.91 / $38.44	Professional	26	$19.94	$21.91	$38.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $58.77 / $60.14 / $72.20	Professional	52	$58.77	$60.14	$72.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.51 / $110.38 / $170.64	Professional	TC	$97.51	$110.38	$170.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.37 / $102.08 / $123.44	Professional		$94.37	$102.08	$123.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $22.28 / $30.42	Professional	26	$15.37	$22.28	$30.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.69 / $325.58 / $350.00	Facility		$145.69	$325.58	$350.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.95 / $145.69 / $196.69	Professional		$120.95	$145.69	$196.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $33.75 / $50.52	Professional	26	$21.08	$33.75	$50.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.97 / $108.20 / $153.66	Professional	TC	$91.97	$108.20	$153.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.14 / $116.02 / $156.63	Facility		$21.14	$116.02	$156.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $111.32 / $150.83	Professional		$20.57	$111.32	$150.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.77 / $350.00 / $350.00	Facility		$145.77	$350.00	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.72 / $24.72 / $24.72	Facility	26	$24.72	$24.72	$24.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.46 / $169.77 / $274.36	Professional		$121.46	$169.77	$274.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $27.96 / $47.66	Professional	26	$21.23	$27.96	$47.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.71 / $144.93 / $238.36	Professional	TC	$99.71	$144.93	$238.36
United Facility/Professional Professional Modifier Low / Median / High Price $117.43 / $160.94 / $253.55	Professional		$117.43	$160.94	$253.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $24.46 / $39.35	Professional	26	$19.32	$24.46	$39.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.80 / $137.99 / $219.50	Professional	TC	$96.80	$137.99	$219.50