Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $81.28 / $120.23	Facility	26	$52.48	$81.28	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $426.58	Professional		$169.82	$275.42	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $194.98	Professional	26	$52.48	$81.28	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $338.84	Professional	TC	$123.03	$190.55	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $66.07	Professional	26	$39.81	$51.29	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $537.03	Professional		$257.04	$302.00	$537.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $75.86 / $125.89	Professional	26	$69.18	$75.86	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $416.87	Professional	TC	$190.55	$223.87	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $79.43	Professional		$50.12	$67.61	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $60.26 / $87.10	Facility	26	$13.18	$60.26	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $416.87 / $1,258.93	Professional		$208.93	$416.87	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $109.65 / $323.59	Professional	26	$53.70	$109.65	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $354.81 / $1,023.29	Professional	TC	$151.36	$354.81	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $181.97	Professional		$32.36	$33.11	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $467.74	Professional		$204.17	$288.40	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $109.65	Professional	26	$53.70	$67.61	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $218.78 / $354.81	Professional	TC	$151.36	$218.78	$354.81