Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.37 / $138.66 / $204.19	Facility	26	$104.37	$138.66	$204.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.25 / $478.24 / $1,125.17	Professional		$426.25	$478.24	$1,125.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.38 / $140.00 / $195.29	Professional	26	$104.38	$140.00	$195.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $321.86 / $366.66 / $694.20	Professional	TC	$321.86	$366.66	$694.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $372.59 / $372.59 / $372.59	Professional		$372.59	$372.59	$372.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $105.37 / $119.16 / $124.90	Professional	26	$105.37	$119.16	$124.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.90 / $569.20 / $875.34	Professional		$426.90	$569.20	$875.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.24 / $108.53 / $174.70	Professional	26	$92.24	$108.53	$174.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $347.88 / $463.84 / $649.37	Professional	TC	$347.88	$463.84	$649.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.66 / $164.87 / $619.85	Professional		$114.66	$164.87	$619.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Facility	26	$122.33	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $557.90 / $989.83 / $1,705.77	Professional		$557.90	$989.83	$1,705.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.20 / $158.51 / $255.63	Professional	26	$99.20	$158.51	$255.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $420.00 / $826.56 / $1,499.70	Professional	TC	$420.00	$826.56	$1,499.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $677.90	Professional		$32.34	$32.34	$677.90
United Facility/Professional Professional Modifier Low / Median / High Price $506.05 / $787.19 / $1,114.39	Professional		$506.05	$787.19	$1,114.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.61 / $121.45 / $160.66	Professional	26	$98.61	$121.45	$160.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $421.12 / $741.98 / $952.57	Professional	TC	$421.12	$741.98	$952.57