Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.51 / $89.08 / $132.05	Facility	26	$67.51	$89.08	$132.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.33 / $427.36 / $696.04	Professional		$271.33	$427.36	$696.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.51 / $100.69 / $200.20	Professional	26	$67.51	$100.69	$200.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.83 / $321.02 / $470.23	Professional	TC	$203.83	$321.02	$470.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.15 / $52.15 / $52.15	Professional	26	$52.15	$52.15	$52.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.99 / $371.76 / $526.13	Professional		$315.99	$371.76	$526.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.80 / $79.90 / $112.55	Professional	26	$66.80	$79.90	$112.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $247.49 / $291.24 / $400.00	Professional	TC	$247.49	$291.24	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.08 / $102.93 / $461.34	Professional		$71.08	$102.93	$461.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.87 / $618.77 / $1,069.19	Professional		$402.87	$618.77	$1,069.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.46 / $108.12 / $164.64	Professional	26	$63.46	$108.12	$164.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.88 / $507.92 / $927.34	Professional	TC	$303.88	$507.92	$927.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $359.52	Professional		$32.34	$32.34	$359.52
United Facility/Professional Professional Modifier Low / Median / High Price $381.76 / $485.24 / $701.14	Professional		$381.76	$485.24	$701.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.89 / $75.06 / $105.10	Professional	26	$64.89	$75.06	$105.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $290.20 / $382.12 / $573.49	Professional	TC	$290.20	$382.12	$573.49