Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.07 / $440.08 / $840.97	Facility		$119.07	$440.08	$840.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.63 / $23.23 / $40.82	Facility	26	$22.63	$23.23	$40.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.91 / $129.16 / $556.00	Professional		$118.91	$129.16	$556.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.29 / $23.07 / $89.97	Professional	26	$20.29	$23.07	$89.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $102.34 / $181.59	Professional	TC	$96.29	$102.34	$181.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $105.25 / $127.23	Professional		$85.80	$105.25	$127.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.54 / $19.05 / $29.46	Professional	26	$16.54	$19.05	$29.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.11 / $114.76 / $192.16	Professional		$88.11	$114.76	$192.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $20.72 / $33.69	Professional	26	$16.82	$20.72	$33.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.28 / $93.91 / $154.91	Professional	TC	$71.28	$93.91	$154.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.35 / $122.63 / $177.81	Facility		$22.35	$122.63	$177.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.14 / $116.83 / $171.68	Professional		$23.14	$116.83	$171.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.64 / $147.30 / $197.24	Facility		$116.64	$147.30	$197.24
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 $130.29 / $202.13 / $346.26	Professional		$130.29	$202.13	$346.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.20 / $28.86 / $46.80	Professional	26	$21.20	$28.86	$46.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.81 / $170.91 / $312.97	Professional	TC	$113.81	$170.91	$312.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $93.12	Professional		$32.34	$32.34	$93.12
United Facility/Professional Professional Modifier Low / Median / High Price $135.88 / $193.63 / $279.52	Professional		$135.88	$193.63	$279.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $25.84 / $46.87	Professional	26	$19.04	$25.84	$46.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $113.93 / $166.49 / $234.38	Professional	TC	$113.93	$166.49	$234.38