Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.27 / $415.00 / $415.00	Facility		$61.27	$415.00	$415.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.39 / $17.39 / $18.37	Facility	26	$17.39	$17.39	$18.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.06 / $66.86 / $139.19	Professional		$60.06	$66.86	$139.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.09 / $17.45 / $21.34	Professional	26	$16.09	$17.45	$21.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.33 / $47.35 / $122.46	Professional	TC	$43.33	$47.35	$122.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $59.52 / $60.10	Professional		$59.52	$59.52	$60.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Professional	26	$32.15	$32.15	$32.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.29 / $415.00 / $415.00	Facility		$124.29	$415.00	$415.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $124.29 / $167.44	Professional		$86.54	$124.29	$167.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $32.72 / $51.86	Professional	26	$16.14	$32.72	$51.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.48 / $27.59 / $108.28	Professional	TC	$20.48	$27.59	$108.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.89 / $51.36 / $80.53	Facility		$17.89	$51.36	$80.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $47.08 / $74.56	Professional		$17.69	$47.08	$74.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $415.00 / $415.00 / $415.00	Facility		$415.00	$415.00	$415.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.23 / $97.04 / $210.19	Professional		$61.23	$97.04	$210.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.79 / $22.98 / $41.11	Professional	26	$18.79	$22.98	$41.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.86 / $72.61 / $171.92	Professional	TC	$36.86	$72.61	$171.92
United Facility/Professional Professional Modifier Low / Median / High Price $59.03 / $99.46 / $155.97	Professional		$59.03	$99.46	$155.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $19.59 / $32.92	Professional	26	$15.77	$19.59	$32.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.30 / $79.63 / $133.55	Professional	TC	$43.30	$79.63	$133.55