Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $83.18 / $107.15	Facility	26	$57.54	$83.18	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $467.74	Professional		$199.53	$275.42	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $147.91	Professional	26	$54.95	$69.18	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $194.98 / $380.19	Professional	TC	$141.25	$194.98	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $144.54	Professional		$141.25	$141.25	$144.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $56.23 / $134.90	Professional	26	$22.91	$56.23	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $331.13 / $562.34	Professional		$281.84	$331.13	$562.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $79.43 / $131.83	Professional	26	$74.13	$79.43	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $416.87	Professional	TC	$208.93	$251.19	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $89.13	Professional		$56.23	$75.86	$89.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $512.86 / $1,479.11	Professional		$269.15	$512.86	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $120.23 / $338.84	Professional	26	$58.88	$120.23	$338.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $416.87 / $1,202.26	Professional	TC	$173.78	$416.87	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $208.93	Professional		$32.36	$33.11	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $524.81	Professional		$223.87	$338.84	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $72.44 / $123.03	Professional	26	$58.88	$72.44	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $257.04 / $398.11	Professional	TC	$165.96	$257.04	$398.11