Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.68 / $110.31 / $206.75	Facility	26	$105.68	$110.31	$206.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.49 / $475.00 / $1,154.07	Professional		$304.49	$475.00	$1,154.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.69 / $154.82 / $498.00	Professional	26	$105.69	$154.82	$498.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $152.25 / $164.80 / $241.05	Professional	52	$152.25	$164.80	$241.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.80 / $335.00 / $688.86	Professional	TC	$198.80	$335.00	$688.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $249.14 / $427.13 / $427.13	Professional		$249.14	$427.13	$427.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.45 / $107.50 / $164.13	Professional	26	$80.45	$107.50	$164.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $183.58 / $183.58 / $183.58	Professional	TC	$183.58	$183.58	$183.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.26 / $403.96 / $695.26	Professional		$343.26	$403.96	$695.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.74 / $126.76 / $193.48	Professional	26	$107.74	$126.76	$193.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.51 / $282.50 / $545.95	Professional	TC	$235.51	$282.50	$545.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $115.66 / $221.41 / $398.65	Professional		$115.66	$221.41	$398.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.88 / $123.88 / $123.88	Facility	26	$123.88	$123.88	$123.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.44 / $881.50 / $1,638.00	Professional		$381.44	$881.50	$1,638.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.01 / $162.75 / $267.30	Professional	26	$103.01	$162.75	$267.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.04 / $691.04 / $1,445.40	Professional	TC	$253.04	$691.04	$1,445.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $699.31	Professional		$32.34	$32.34	$699.31
United Facility/Professional Professional Modifier Low / Median / High Price $331.52 / $501.17 / $1,076.05	Professional		$331.52	$501.17	$1,076.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.80 / $121.58 / $169.08	Professional	26	$102.80	$121.58	$169.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.73 / $437.47 / $888.39	Professional	TC	$223.73	$437.47	$888.39