Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.01 / $124.83 / $194.88	Professional		$107.01	$124.83	$194.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.15 / $32.56	Professional	26	$11.77	$22.15	$32.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.20 / $105.73 / $163.27	Professional	TC	$95.20	$105.73	$163.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $113.84 / $153.72	Professional		$107.71	$113.84	$153.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.44 / $16.44 / $20.55	Professional	26	$16.44	$16.44	$20.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $350.00 / $350.00	Facility		$350.00	$350.00	$350.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $120.44 / $190.89	Professional		$91.28	$120.44	$190.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $15.98 / $25.38	Professional	26	$11.33	$15.98	$25.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.94 / $104.46 / $165.57	Professional	TC	$79.94	$104.46	$165.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.71 / $129.28 / $170.26	Facility		$22.71	$129.28	$170.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $125.04 / $163.10	Professional		$21.58	$125.04	$163.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $147.68 / $350.00	Facility		$147.68	$147.68	$350.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.39 / $176.90 / $299.00	Professional		$120.39	$176.90	$299.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.45 / $23.16 / $41.52	Professional	26	$13.45	$23.16	$41.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.37 / $156.52 / $265.41	Professional	TC	$109.37	$156.52	$265.41
United Facility/Professional Professional Modifier Low / Median / High Price $131.50 / $169.95 / $259.00	Professional		$131.50	$169.95	$259.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $23.06 / $33.65	Professional	26	$12.45	$23.06	$33.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.23 / $146.76 / $221.57	Professional	TC	$110.23	$146.76	$221.57