Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.41 / $80.54 / $141.53	Facility	26	$74.41	$80.54	$141.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.09 / $281.35 / $543.33	Professional		$211.09	$281.35	$543.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $77.34 / $142.28	Professional	26	$62.17	$77.34	$142.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.66 / $185.03 / $402.89	Professional	TC	$136.66	$185.03	$402.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.20 / $167.20 / $177.40	Professional		$167.20	$167.20	$177.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.64 / $84.96 / $88.65	Professional	26	$56.64	$84.96	$88.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.37 / $298.08 / $456.09	Professional		$253.37	$298.08	$456.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.09 / $80.11 / $118.49	Professional	26	$68.09	$80.11	$118.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.42 / $217.98 / $327.35	Professional	TC	$178.42	$217.98	$327.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $113.47 / $284.08	Professional		$78.37	$113.47	$284.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.31 / $427.66 / $709.00	Professional		$264.31	$427.66	$709.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.43 / $110.22 / $163.81	Professional	26	$65.43	$110.22	$163.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.81 / $326.22 / $567.88	Professional	TC	$173.81	$326.22	$567.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $256.33	Professional		$32.34	$32.34	$256.33
United Facility/Professional Professional Modifier Low / Median / High Price $224.51 / $323.77 / $454.68	Professional		$224.51	$323.77	$454.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $83.32 / $125.06	Professional	26	$66.70	$83.32	$125.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.80 / $231.40 / $344.97	Professional	TC	$143.80	$231.40	$344.97