Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.63 / $1,291.06 / $2,305.94	Facility		$203.63	$1,291.06	$2,305.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.16 / $37.39 / $51.04	Facility	26	$31.16	$37.39	$51.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $142.13 / $167.12 / $728.43	Facility	TC	$142.13	$167.12	$728.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.56 / $199.53 / $329.62	Professional		$172.56	$199.53	$329.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.67 / $34.88 / $59.81	Professional	26	$30.67	$34.88	$59.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.83 / $161.41 / $204.52	Professional	TC	$140.83	$161.41	$204.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $136.69 / $248.34	Professional		$132.44	$136.69	$248.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $27.57 / $44.54	Professional	26	$23.74	$27.57	$44.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $124.67 / $183.42 / $208.92	Professional	TC	$124.67	$183.42	$208.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $172.47 / $350.00 / $548.41	Facility		$172.47	$350.00	$548.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.85 / $172.47 / $244.90	Professional		$139.85	$172.47	$244.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.24 / $32.15 / $45.65	Professional	26	$27.24	$32.15	$45.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.61 / $140.33 / $199.26	Professional	TC	$112.61	$140.33	$199.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.65 / $163.04 / $223.51	Facility		$32.65	$163.04	$223.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.77 / $156.25 / $215.23	Professional		$31.77	$156.25	$215.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.15 / $350.00 / $382.10	Facility		$209.15	$350.00	$382.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.51 / $37.51 / $37.51	Facility	26	$37.51	$37.51	$37.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $172.98 / $172.98 / $172.98	Facility	TC	$172.98	$172.98	$172.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $240.76 / $390.70	Professional		$172.00	$240.76	$390.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $40.86 / $71.70	Professional	26	$32.25	$40.86	$71.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.94 / $200.29 / $350.00	Professional	TC	$146.94	$200.29	$350.00
United Facility/Professional Professional Modifier Low / Median / High Price $172.89 / $235.37 / $363.64	Professional		$172.89	$235.37	$363.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $36.99 / $58.22	Professional	26	$30.06	$36.99	$58.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.96 / $203.42 / $343.77	Professional	TC	$138.96	$203.42	$343.77