Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $220.98 / $938.47 / $1,742.00	Facility		$220.98	$938.47	$1,742.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.13 / $40.04 / $45.39	Facility	26	$35.13	$40.04	$45.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $185.84 / $185.85 / $242.04	Facility	TC	$185.84	$185.85	$242.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.60 / $225.49 / $386.71	Professional		$183.60	$225.49	$386.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $36.77 / $53.39	Professional	26	$26.96	$36.77	$53.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $185.87 / $242.04	Professional	TC	$162.34	$185.87	$242.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.40 / $169.40 / $184.88	Professional		$169.40	$169.40	$184.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.11 / $27.96 / $50.97	Professional	26	$27.11	$27.96	$50.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $225.70 / $350.00 / $548.41	Facility		$225.70	$350.00	$548.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.93 / $225.70 / $311.45	Professional		$163.93	$225.70	$311.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $41.60 / $57.28	Professional	26	$29.86	$41.60	$57.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.44 / $184.20 / $254.19	Professional	TC	$132.44	$184.20	$254.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.54 / $211.76 / $285.88	Facility		$37.54	$211.76	$285.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.68 / $204.14 / $275.29	Professional		$35.68	$204.14	$275.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.80 / $350.00 / $516.13	Facility		$268.80	$350.00	$516.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $42.91	Facility	26	$42.91	$42.91	$42.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $227.42	Facility	TC	$227.42	$227.42	$227.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.55 / $298.23 / $502.90	Professional		$198.55	$298.23	$502.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.81 / $40.39 / $76.45	Professional	26	$30.81	$40.39	$76.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.13 / $257.07 / $434.52	Professional	TC	$178.13	$257.07	$434.52
United Facility/Professional Professional Modifier Low / Median / High Price $219.95 / $283.95 / $437.51	Professional		$219.95	$283.95	$437.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $40.06 / $64.48	Professional	26	$29.89	$40.06	$64.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.90 / $233.70 / $392.62	Professional	TC	$185.90	$233.70	$392.62