Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.68 / $110.31 / $207.35	Facility	26	$105.68	$110.31	$207.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.38 / $475.00 / $1,092.60	Professional		$305.38	$475.00	$1,092.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.69 / $145.65 / $372.96	Professional	26	$105.69	$145.65	$372.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.68 / $335.00 / $730.50	Professional	TC	$199.68	$335.00	$730.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.14 / $234.72 / $363.41	Professional		$178.14	$234.72	$363.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $100.87 / $131.90	Professional	26	$80.69	$100.87	$131.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $342.60 / $403.64 / $678.68	Professional		$342.60	$403.64	$678.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.27 / $127.38 / $199.12	Professional	26	$108.27	$127.38	$199.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.31 / $285.00 / $530.54	Professional	TC	$234.31	$285.00	$530.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $221.41 / $399.04	Professional		$116.00	$221.41	$399.04
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 $382.59 / $859.09 / $1,633.20	Professional		$382.59	$859.09	$1,633.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.73 / $162.75 / $269.27	Professional	26	$102.73	$162.75	$269.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.81 / $693.14 / $1,440.60	Professional	TC	$253.81	$693.14	$1,440.60
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 $311.48 / $559.22 / $1,048.51	Professional		$311.48	$559.22	$1,048.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.80 / $123.24 / $169.08	Professional	26	$102.80	$123.24	$169.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.92 / $383.28 / $883.34	Professional	TC	$228.92	$383.28	$883.34