Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.67 / $610.92 / $1,254.43	Facility		$117.67	$610.92	$1,254.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.37 / $21.38 / $25.65	Facility	26	$21.37	$21.38	$25.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.67 / $124.35 / $206.32	Professional		$117.67	$124.35	$206.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $22.63 / $37.49	Professional	26	$18.44	$22.63	$37.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $102.26 / $120.63	Professional	TC	$96.29	$102.26	$120.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.16 / $111.16 / $111.16	Professional		$111.16	$111.16	$111.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.54 / $17.07 / $31.02	Professional	26	$16.54	$17.07	$31.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.10 / $291.62 / $350.00	Facility		$151.10	$291.62	$350.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $151.10 / $208.06	Professional		$103.66	$151.10	$208.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $28.20 / $38.07	Professional	26	$19.80	$28.20	$38.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.86 / $122.90 / $169.60	Professional	TC	$83.86	$122.90	$169.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.75 / $127.02 / $171.48	Facility		$22.75	$127.02	$171.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.97 / $122.29 / $165.13	Professional		$21.97	$122.29	$165.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.30 / $350.00 / $350.00	Facility		$147.30	$350.00	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.35 / $26.35 / $26.35	Facility	26	$26.35	$26.35	$26.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $182.44 / $303.20	Professional		$130.28	$182.44	$303.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.20 / $25.68 / $45.45	Professional	26	$20.20	$25.68	$45.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.33 / $157.05 / $261.42	Professional	TC	$112.33	$157.05	$261.42
United Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $169.85 / $277.83	Professional		$130.07	$169.85	$277.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.90 / $39.97	Professional	26	$19.95	$24.90	$39.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.68 / $145.66 / $244.53	Professional	TC	$108.68	$145.66	$244.53