Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.33 / $798.21 / $1,160.15	Facility		$193.33	$798.21	$1,160.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.68 / $38.00 / $66.44	Facility	26	$36.68	$38.00	$66.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $156.63 / $189.47 / $1,029.38	Facility	TC	$156.63	$189.47	$1,029.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $227.26 / $430.29	Professional		$189.31	$227.26	$430.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $37.06 / $69.81	Professional	26	$26.96	$37.06	$69.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $185.87 / $338.80	Professional	TC	$162.34	$185.87	$338.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.32 / $169.40 / $204.14	Professional		$163.32	$169.40	$204.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.18 / $32.65 / $48.24	Professional	26	$27.18	$32.65	$48.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.34 / $179.00 / $315.23	Professional		$139.34	$179.00	$315.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.76 / $31.49 / $53.10	Professional	26	$26.76	$31.49	$53.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.57 / $148.21 / $256.24	Professional	TC	$112.57	$148.21	$256.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $202.50 / $296.00	Facility		$35.15	$202.50	$296.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $195.14 / $285.80	Professional		$37.90	$195.14	$285.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.13 / $268.80 / $439.62	Facility		$265.13	$268.80	$439.62
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 $216.52 / $326.05 / $550.99	Professional		$216.52	$326.05	$550.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $43.44 / $75.97	Professional	26	$32.96	$43.44	$75.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.47 / $287.51 / $493.68	Professional	TC	$181.47	$287.51	$493.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $139.28	Professional		$32.34	$32.34	$139.28
United Facility/Professional Professional Modifier Low / Median / High Price $229.35 / $326.05 / $472.13	Professional		$229.35	$326.05	$472.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $39.86 / $77.62	Professional	26	$27.94	$39.86	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.01 / $267.98 / $391.73	Professional	TC	$196.01	$267.98	$391.73