Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.69 / $158.53 / $222.58	Facility	26	$105.69	$158.53	$222.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.56 / $475.00 / $1,110.43	Professional		$306.56	$475.00	$1,110.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.69 / $150.03 / $368.06	Professional	26	$105.69	$150.03	$368.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.87 / $335.00 / $462.42	Professional	TC	$200.87	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.67 / $429.26 / $429.26	Professional		$235.67	$429.26	$429.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $100.87 / $131.90	Professional	26	$81.17	$100.87	$131.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.87 / $414.04 / $682.50	Professional		$343.87	$414.04	$682.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.75 / $129.04 / $203.34	Professional	26	$107.75	$129.04	$203.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $236.12 / $285.00 / $526.08	Professional	TC	$236.12	$285.00	$526.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $221.65 / $400.64	Professional		$113.17	$221.65	$400.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $384.12 / $882.91 / $1,643.79	Professional		$384.12	$882.91	$1,643.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.64 / $173.39 / $291.68	Professional	26	$111.64	$173.39	$291.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $255.34 / $703.29 / $1,419.04	Professional	TC	$255.34	$703.29	$1,419.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $699.31	Professional		$32.34	$32.34	$699.31
United Facility/Professional Professional Modifier Low / Median / High Price $355.98 / $699.90 / $1,021.95	Professional		$355.98	$699.90	$1,021.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.15 / $129.69 / $175.94	Professional	26	$106.15	$129.69	$175.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.33 / $336.83 / $905.58	Professional	TC	$217.33	$336.83	$905.58