Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.89 / $86.84 / $153.41	Facility	26	$80.89	$86.84	$153.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.27 / $385.88 / $715.05	Professional		$238.27	$385.88	$715.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.65 / $88.35 / $227.50	Professional	26	$75.65	$88.35	$227.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.38 / $291.14 / $554.03	Professional	TC	$157.38	$291.14	$554.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.18 / $203.18 / $203.18	Professional		$203.18	$203.18	$203.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $86.61 / $96.05	Professional	26	$61.32	$86.61	$96.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.26 / $372.80 / $523.60	Professional		$278.26	$372.80	$523.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.09 / $95.40 / $150.37	Professional	26	$81.09	$95.40	$150.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $272.00 / $374.30	Professional	TC	$190.00	$272.00	$374.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.52 / $194.48 / $344.33	Professional		$84.52	$194.48	$344.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.21 / $540.15 / $1,099.24	Professional		$329.21	$540.15	$1,099.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $123.58 / $198.51	Professional	26	$76.92	$123.58	$198.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.17 / $426.26 / $932.09	Professional	TC	$231.17	$426.26	$932.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $273.38	Professional		$32.34	$32.34	$273.38
United Facility/Professional Professional Modifier Low / Median / High Price $270.89 / $452.03 / $650.16	Professional		$270.89	$452.03	$650.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.51 / $91.05 / $134.25	Professional	26	$76.51	$91.05	$134.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.42 / $366.85 / $530.83	Professional	TC	$192.42	$366.85	$530.83