Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.66 / $1,012.99 / $1,504.49	Facility		$178.66	$1,012.99	$1,504.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.96 / $33.65 / $58.06	Facility	26	$32.96	$33.65	$58.06
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $138.90 / $173.37 / $783.02	Facility	TC	$138.90	$173.37	$783.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.56 / $214.07 / $536.25	Professional		$172.56	$214.07	$536.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.73 / $36.27 / $144.00	Professional	26	$31.73	$36.27	$144.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.90 / $162.49 / $264.01	Professional	TC	$138.90	$162.49	$264.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.80 / $137.04 / $159.75	Professional		$127.80	$137.04	$159.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.75 / $28.48 / $42.11	Professional	26	$23.75	$28.48	$42.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.85 / $168.65 / $268.64	Professional		$139.85	$168.65	$268.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.24 / $32.15 / $51.50	Professional	26	$27.24	$32.15	$51.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.60 / $136.29 / $212.85	Professional	TC	$112.60	$136.29	$212.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.68 / $158.53 / $231.64	Facility		$30.68	$158.53	$231.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $149.13 / $223.65	Professional		$32.65	$149.13	$223.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.15 / $209.15 / $439.62	Facility		$209.15	$209.15	$439.62
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 $170.57 / $267.95 / $450.90	Professional		$170.57	$267.95	$450.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $47.98 / $70.52	Professional	26	$31.34	$47.98	$70.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.25 / $217.64 / $388.08	Professional	TC	$144.25	$217.64	$388.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $178.64	Professional		$32.34	$32.34	$178.64
United Facility/Professional Professional Modifier Low / Median / High Price $178.77 / $255.17 / $362.50	Professional		$178.77	$255.17	$362.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.18 / $41.65 / $68.56	Professional	26	$30.18	$41.65	$68.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.19 / $208.28 / $299.38	Professional	TC	$144.19	$208.28	$299.38