Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.00 / $265.69 / $636.38	Facility		$119.00	$265.69	$636.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.49 / $22.32 / $38.39	Facility	26	$21.49	$22.32	$38.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $178.25 / $302.06	Professional		$119.00	$178.25	$302.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.71 / $22.24 / $40.53	Professional	26	$20.71	$22.24	$40.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $58.77 / $60.14 / $62.68	Professional	52	$58.77	$60.14	$62.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.51 / $138.18 / $238.50	Professional	TC	$97.51	$138.18	$238.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $18.78 / $25.64	Professional	26	$15.37	$18.78	$25.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.95 / $142.30 / $190.23	Professional		$120.95	$142.30	$190.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $23.29 / $36.63	Professional	26	$17.91	$23.29	$36.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.80 / $121.21 / $157.72	Professional	TC	$102.80	$121.21	$157.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.18 / $111.69 / $162.72	Facility		$20.18	$111.69	$162.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $106.39 / $157.12	Professional		$21.69	$106.39	$157.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.77 / $145.77 / $280.25	Facility		$145.77	$145.77	$280.25
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 $117.71 / $188.40 / $313.06	Professional		$117.71	$188.40	$313.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $31.02 / $46.39	Professional	26	$20.60	$31.02	$46.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.71 / $160.47 / $268.35	Professional	TC	$99.71	$160.47	$268.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $94.82	Professional		$32.34	$32.34	$94.82
United Facility/Professional Professional Modifier Low / Median / High Price $121.21 / $172.00 / $251.05	Professional		$121.21	$172.00	$251.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $27.25 / $44.19	Professional	26	$19.92	$27.25	$44.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.97 / $151.99 / $207.60	Professional	TC	$102.97	$151.99	$207.60