Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $97.72 / $123.03	Facility	26	$67.61	$97.72	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $1,023.29	Professional		$323.59	$478.63	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $117.49 / $245.47	Professional	26	$67.61	$117.49	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $338.84 / $794.33	Professional	TC	$239.88	$338.84	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $234.42 / $245.47	Professional		$218.78	$234.42	$245.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $154.88	Professional	26	$51.29	$72.44	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $588.84 / $912.01	Professional		$467.74	$588.84	$912.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $97.72 / $169.82	Professional	26	$91.20	$97.72	$169.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $489.78 / $724.44	Professional	TC	$380.19	$489.78	$724.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $251.19 / $389.05	Professional		$70.79	$251.19	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $1,096.48 / $3,981.07	Professional		$407.38	$1,096.48	$3,981.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $144.54 / $426.58	Professional	26	$70.79	$144.54	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $912.01 / $2,754.23	Professional	TC	$309.03	$912.01	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $616.60	Professional		$32.36	$33.11	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $758.58 / $1,096.48	Professional		$338.84	$758.58	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $125.89	Professional	26	$69.18	$89.13	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $676.08 / $977.24	Professional	TC	$263.03	$676.08	$977.24