Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.11 / $105.61 / $129.36	Facility	26	$105.11	$105.61	$129.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.93 / $350.44 / $473.69	Professional		$346.93	$350.44	$473.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.11 / $105.69 / $139.76	Professional	26	$105.11	$105.69	$139.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.83 / $245.28 / $330.18	Professional	TC	$241.83	$245.28	$330.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $354.99 / $354.99 / $354.99	Professional		$354.99	$354.99	$354.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $252.04 / $305.42 / $446.02	Professional		$252.04	$305.42	$446.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.25 / $113.01 / $146.88	Professional	26	$93.25	$113.01	$146.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.78 / $192.41 / $308.51	Professional	TC	$158.78	$192.41	$308.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.06 / $194.88 / $451.96	Professional		$112.06	$194.88	$451.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.35 / $120.35 / $120.35	Facility	26	$120.35	$120.35	$120.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.24 / $407.46 / $643.44	Professional		$298.24	$407.46	$643.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.74 / $151.94 / $233.69	Professional	26	$103.74	$151.94	$233.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.30 / $255.26 / $426.28	Professional	TC	$185.30	$255.26	$426.28
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 $285.26 / $426.27 / $635.20	Professional		$285.26	$426.27	$635.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.46 / $157.53 / $223.25	Professional	26	$108.46	$157.53	$223.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.97 / $262.08 / $424.61	Professional	TC	$188.97	$262.08	$424.61