Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $112.20 / $128.82	Facility	26	$104.71	$112.20	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $512.86	Professional		$338.84	$380.19	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $123.03 / $190.55	Professional	26	$100.00	$123.03	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $380.19	Professional	TC	$229.09	$269.15	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $426.58	Professional		$257.04	$302.00	$426.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $144.54	Professional	26	$95.50	$112.20	$144.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $190.55 / $281.84	Professional	TC	$162.18	$190.55	$281.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $162.18	Professional		$97.72	$134.90	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $125.89 / $177.83	Facility	26	$26.92	$125.89	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $1,584.89	Professional		$323.59	$524.81	$1,584.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $177.83 / $489.78	Professional	26	$109.65	$177.83	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $331.13 / $1,096.48	Professional	TC	$204.17	$331.13	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $630.96	Professional		$288.40	$398.11	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $147.91 / $208.93	Professional	26	$102.33	$147.91	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $416.87	Professional	TC	$190.55	$245.47	$416.87