Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $72.44 / $123.03	Facility	26	$67.61	$72.44	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $389.05 / $1,258.93	Professional		$194.98	$389.05	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $125.89 / $346.74	Professional	26	$66.07	$125.89	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $229.09 / $501.19	Professional	TC	$123.03	$229.09	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $154.88 / $371.54	Professional		$70.79	$154.88	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $128.82	Professional	26	$52.48	$74.13	$128.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $109.65 / $154.88	Professional	TC	$63.10	$109.65	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $724.44	Professional		$245.47	$288.40	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $85.11 / $151.36	Professional	26	$79.43	$85.11	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $165.96 / $575.44	Professional	TC	$162.18	$165.96	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $229.09	Professional		$72.44	$125.89	$229.09
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 $223.87 / $691.83 / $2,398.83	Professional		$223.87	$691.83	$2,398.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $134.90 / $380.19	Professional	26	$69.18	$134.90	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $501.19 / $1,479.11	Professional	TC	$141.25	$501.19	$1,479.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $346.74	Professional		$32.36	$33.11	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $446.68 / $630.96	Professional		$199.53	$446.68	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.28 / $117.49	Professional	26	$67.61	$81.28	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $309.03 / $524.81	Professional	TC	$125.89	$309.03	$524.81