Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.68 / $350.00 / $877.79	Facility		$165.68	$350.00	$877.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.15 / $40.81 / $46.93	Facility	26	$35.15	$40.81	$46.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.68 / $189.19 / $290.08	Professional		$165.68	$189.19	$290.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $37.10 / $63.72	Professional	26	$30.82	$37.10	$63.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.22 / $148.38 / $178.73	Professional	TC	$130.22	$148.38	$178.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.97 / $170.61 / $175.58	Professional		$141.97	$170.61	$175.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.19 / $49.40 / $55.37	Professional	26	$41.19	$49.40	$55.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.60 / $350.00 / $548.41	Facility		$235.60	$350.00	$548.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.22 / $235.60 / $318.06	Professional		$163.22	$235.60	$318.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $45.60 / $61.77	Professional	26	$30.73	$45.60	$61.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.82 / $189.04 / $256.50	Professional	TC	$129.82	$189.04	$256.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $151.24 / $216.47	Facility		$37.92	$151.24	$216.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.36 / $144.93 / $208.46	Professional		$36.36	$144.93	$208.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.70 / $350.00 / $355.28	Facility		$201.70	$350.00	$355.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.31 / $43.31 / $43.31	Facility	26	$43.31	$43.31	$43.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.30 / $233.46 / $378.54	Professional		$173.30	$233.46	$378.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $42.82 / $77.22	Professional	26	$32.78	$42.82	$77.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.82 / $185.87 / $313.02	Professional	TC	$135.82	$185.87	$313.02
United Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $350.00 / $350.00	Facility		$350.00	$350.00	$350.00
United Facility/Professional Professional Modifier Low / Median / High Price $162.91 / $212.13 / $335.05	Professional		$162.91	$212.13	$335.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.18 / $40.42 / $65.68	Professional	26	$33.18	$40.42	$65.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.87 / $176.81 / $281.26	Professional	TC	$131.87	$176.81	$281.26