Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $325.97 / $325.97 / $325.97	Facility		$325.97	$325.97	$325.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.78 / $164.78 / $164.78	Facility	26	$164.78	$164.78	$164.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $161.19 / $161.19 / $161.19	Facility	TC	$161.19	$161.19	$161.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $325.97 / $508.56 / $606.19	Professional		$325.97	$508.56	$606.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $143.80 / $164.75 / $271.14	Professional	26	$143.80	$164.75	$271.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.19 / $335.02 / $406.69	Professional	TC	$161.19	$335.02	$406.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $208.99 / $208.99 / $208.99	Professional	26	$208.99	$208.99	$208.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $173.81 / $751.00	Professional		$173.81	$173.81	$751.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $74.73 / $182.96	Professional	26	$74.73	$74.73	$182.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $287.70 / $383.60 / $419.22	Professional	TC	$287.70	$383.60	$419.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $225.06 / $230.41 / $455.48	Facility		$225.06	$230.41	$455.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $160.88 / $242.03 / $470.95	Professional		$160.88	$242.03	$470.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $845.83 / $845.83 / $845.83	Facility		$845.83	$845.83	$845.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $197.83 / $197.83 / $197.83	Facility	26	$197.83	$197.83	$197.83
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $215.75 / $215.75 / $215.75	Facility	TC	$215.75	$215.75	$215.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $412.29 / $656.39	Professional		$326.16	$412.29	$656.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $151.68 / $153.56 / $257.76	Professional	26	$151.68	$153.56	$257.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $223.84 / $455.11	Professional	TC	$172.60	$223.84	$455.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $315.43 / $445.72 / $695.80	Professional		$315.43	$445.72	$695.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $165.24 / $183.99 / $353.21	Professional	26	$165.24	$183.99	$353.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.88 / $227.36 / $443.44	Professional	TC	$141.88	$227.36	$443.44