Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.57 / $701.90 / $1,121.95	Facility		$151.57	$701.90	$1,121.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.18 / $42.19 / $50.32	Facility	26	$42.18	$42.19	$50.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.41 / $160.41 / $252.16	Professional		$139.41	$160.41	$252.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $44.62 / $70.06	Professional	26	$37.96	$44.62	$70.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.69 / $115.86 / $175.00	Professional	TC	$98.69	$115.86	$175.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.12 / $116.26 / $117.06	Professional		$108.12	$116.26	$117.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $44.55 / $60.29	Professional	26	$33.50	$44.55	$60.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.25 / $99.25 / $104.47	Professional	TC	$99.25	$99.25	$104.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $192.46 / $706.94 / $2,014.00	Facility		$192.46	$706.94	$2,014.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.96 / $192.46 / $273.29	Professional		$153.96	$192.46	$273.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.84 / $78.15 / $118.25	Professional	26	$49.84	$78.15	$118.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.97 / $114.30 / $162.30	Professional	TC	$78.97	$114.30	$162.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.29 / $96.29 / $151.13	Facility		$37.29	$96.29	$151.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.82 / $92.28 / $145.33	Professional		$37.82	$92.28	$145.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $818.57 / $818.57 / $819.00	Facility		$818.57	$818.57	$819.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.41 / $223.12 / $357.97	Professional		$141.41	$223.12	$357.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.85 / $65.19 / $103.01	Professional	26	$40.85	$65.19	$103.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.99 / $157.94 / $250.32	Professional	TC	$98.99	$157.94	$250.32
United Facility/Professional Professional Modifier Low / Median / High Price $142.68 / $206.63 / $359.81	Professional		$142.68	$206.63	$359.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.33 / $57.54 / $103.16	Professional	26	$38.33	$57.54	$103.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.00 / $146.22 / $250.46	Professional	TC	$102.00	$146.22	$250.46