Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.79 / $119.48 / $162.26	Facility	26	$82.79	$119.48	$162.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.36 / $320.49 / $522.50	Professional		$262.36	$320.49	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.79 / $94.10 / $163.92	Professional	26	$82.79	$94.10	$163.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.57 / $213.10 / $368.50	Professional	TC	$179.57	$213.10	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $110.95 / $110.95 / $110.95	Professional	26	$110.95	$110.95	$110.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.18 / $382.44 / $554.53	Professional		$291.18	$382.44	$554.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.93 / $98.74 / $156.02	Professional	26	$83.93	$98.74	$156.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $207.24 / $273.05 / $432.85	Professional	TC	$207.24	$273.05	$432.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.14 / $126.80 / $363.02	Professional		$91.14	$126.80	$363.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.51 / $613.57 / $1,153.24	Professional		$329.51	$613.57	$1,153.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.77 / $132.54 / $218.24	Professional	26	$83.77	$132.54	$218.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.87 / $501.16 / $965.98	Professional	TC	$228.87	$501.16	$965.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $377.80	Professional		$32.34	$32.34	$377.80
United Facility/Professional Professional Modifier Low / Median / High Price $287.99 / $431.99 / $694.86	Professional		$287.99	$431.99	$694.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $98.75 / $137.51	Professional	26	$82.50	$98.75	$137.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.54 / $280.72 / $580.04	Professional	TC	$193.54	$280.72	$580.04