Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.10 / $849.76 / $1,545.43	Facility		$105.10	$849.76	$1,545.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.01 / $23.61 / $25.53	Facility	26	$20.01	$23.61	$25.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $89.87 / $107.84 / $489.27	Facility	TC	$89.87	$107.84	$489.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $123.43 / $226.78	Professional		$25.68	$123.43	$226.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $23.55 / $42.00	Professional	26	$19.80	$23.55	$42.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.54 / $102.26 / $168.67	Professional	TC	$89.54	$102.26	$168.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $92.44 / $153.41	Professional		$84.65	$92.44	$153.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.33 / $16.78 / $28.80	Professional	26	$15.33	$16.78	$28.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $130.19 / $130.19 / $133.49	Professional	TC	$130.19	$130.19	$133.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.18 / $263.76 / $350.00	Facility		$114.18	$263.76	$350.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $114.18 / $162.13	Professional		$91.34	$114.18	$162.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $21.99 / $31.22	Professional	26	$17.91	$21.99	$31.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.75 / $92.19 / $131.10	Professional	TC	$73.75	$92.19	$131.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.12 / $104.16 / $143.10	Facility		$21.12	$104.16	$143.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.16 / $99.82 / $137.80	Professional		$20.16	$99.82	$137.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.10 / $350.00 / $350.00	Facility		$133.10	$350.00	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $23.98	Facility	26	$23.98	$23.98	$23.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $109.98	Facility	TC	$109.98	$109.98	$109.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.11 / $155.38 / $266.61	Professional		$114.11	$155.38	$266.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.85 / $26.56 / $46.31	Professional	26	$20.85	$26.56	$46.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.41 / $129.81 / $278.98	Professional	TC	$93.41	$129.81	$278.98
United Facility/Professional Professional Modifier Low / Median / High Price $106.40 / $155.90 / $244.51	Professional		$106.40	$155.90	$244.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.94 / $24.86 / $40.00	Professional	26	$19.94	$24.86	$40.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.44 / $121.52 / $204.59	Professional	TC	$84.44	$121.52	$204.59