Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.58 / $305.52 / $961.99	Facility		$171.58	$305.52	$961.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.65 / $41.11 / $67.23	Facility	26	$37.65	$41.11	$67.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.96 / $204.21 / $364.65	Professional		$166.96	$204.21	$364.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.90 / $38.39 / $70.25	Professional	26	$33.90	$38.39	$70.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.22 / $162.49 / $254.79	Professional	TC	$130.22	$162.49	$254.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.97 / $155.97 / $155.97	Professional		$155.97	$155.97	$155.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.82 / $39.22 / $49.92	Professional	26	$22.82	$39.22	$49.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.72 / $165.02 / $274.87	Professional		$138.72	$165.02	$274.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $34.06 / $53.51	Professional	26	$26.12	$34.06	$53.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.60 / $132.47 / $231.16	Professional	TC	$112.60	$132.47	$231.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.65 / $148.28 / $226.17	Facility		$37.65	$148.28	$226.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.92 / $137.57 / $218.37	Professional		$38.92	$137.57	$218.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.70 / $201.70 / $439.62	Facility		$201.70	$201.70	$439.62
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 $168.99 / $257.24 / $421.59	Professional		$168.99	$257.24	$421.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.71 / $48.76 / $76.44	Professional	26	$34.71	$48.76	$76.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.63 / $201.28 / $361.35	Professional	TC	$134.63	$201.28	$361.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $144.96	Professional		$32.34	$32.34	$144.96
United Facility/Professional Professional Modifier Low / Median / High Price $168.99 / $241.41 / $358.58	Professional		$168.99	$241.41	$358.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $42.44 / $78.55	Professional	26	$31.12	$42.44	$78.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.36 / $202.59 / $277.33	Professional	TC	$134.36	$202.59	$277.33