Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $89.13 / $120.23	Facility	26	$81.28	$89.13	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $851.14	Professional		$257.04	$398.11	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $389.05	Professional	26	$83.18	$123.03	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $281.84 / $537.03	Professional	TC	$186.21	$281.84	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $79.43 / $190.55	Professional	26	$63.10	$79.43	$190.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	TC	$134.90	$134.90	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $371.54 / $812.83	Professional		$331.13	$371.54	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $100.00 / $165.96	Professional	26	$93.33	$100.00	$165.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $239.88 / $660.69	Professional	TC	$234.42	$239.88	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $125.89	Professional		$72.44	$107.15	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $741.31 / $2,630.27	Professional		$316.23	$741.31	$2,630.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $151.36 / $426.58	Professional	26	$81.28	$151.36	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $588.84 / $1,778.28	Professional	TC	$218.78	$588.84	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $537.03 / $707.95	Professional		$281.84	$537.03	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $138.04	Professional	26	$79.43	$93.33	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $416.87 / $602.56	Professional	TC	$194.98	$416.87	$602.56