Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.87 / $131.60 / $193.87	Facility	26	$98.87	$131.60	$193.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.41 / $475.00 / $1,123.89	Professional		$323.41	$475.00	$1,123.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.88 / $140.00 / $513.24	Professional	26	$98.88	$140.00	$513.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.53 / $335.00 / $631.87	Professional	TC	$224.53	$335.00	$631.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.15 / $248.63 / $264.17	Professional		$224.15	$248.63	$264.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.95 / $111.36 / $118.66	Professional	26	$75.95	$111.36	$118.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.83 / $515.03 / $685.34	Professional		$389.83	$515.03	$685.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.20 / $114.87 / $164.28	Professional	26	$90.20	$114.87	$164.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $396.71 / $559.35	Professional	TC	$285.00	$396.71	$559.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.86 / $237.21 / $421.68	Professional		$105.86	$237.21	$421.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.33 / $870.06 / $1,604.40	Professional		$405.33	$870.06	$1,604.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.68 / $150.31 / $242.21	Professional	26	$93.68	$150.31	$242.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.88 / $751.00 / $1,428.00	Professional	TC	$284.88	$751.00	$1,428.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $681.53	Professional		$32.34	$32.34	$681.53
United Facility/Professional Professional Modifier Low / Median / High Price $355.28 / $621.19 / $1,038.91	Professional		$355.28	$621.19	$1,038.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.44 / $114.65 / $157.77	Professional	26	$93.44	$114.65	$157.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.10 / $503.93 / $894.02	Professional	TC	$250.10	$503.93	$894.02