Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $151.36 / $190.55	Facility	26	$104.71	$151.36	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $2,089.30	Professional		$331.13	$478.63	$2,089.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $165.96 / $436.52	Professional	26	$104.71	$165.96	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $331.13 / $724.44	Professional	TC	$208.93	$331.13	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $707.95	Professional		$234.42	$302.00	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $104.71 / $199.53	Professional	26	$81.28	$104.71	$199.53
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $204.17 / $275.42	Professional	TC	$190.55	$204.17	$275.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $954.99	Professional		$389.05	$446.68	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $134.90 / $234.42	Professional	26	$123.03	$134.90	$234.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $275.42 / $707.95	Professional	TC	$269.15	$275.42	$707.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $213.80 / $380.19	Professional		$112.20	$213.80	$380.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $123.03 / $177.83	Facility	26	$26.92	$123.03	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $1,071.52 / $4,677.35	Professional		$398.11	$1,071.52	$4,677.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $194.98 / $602.56	Professional	26	$107.15	$194.98	$602.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $794.33 / $2,187.76	Professional	TC	$251.19	$794.33	$2,187.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $691.83	Professional		$32.36	$33.11	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $660.69 / $1,122.02	Professional		$331.13	$660.69	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $128.82 / $186.21	Professional	26	$107.15	$128.82	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $489.78 / $977.24	Professional	TC	$223.87	$489.78	$977.24