Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.20 / $105.48 / $155.88	Facility	26	$80.20	$105.48	$155.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.52 / $297.05 / $566.76	Professional		$256.52	$297.05	$566.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.20 / $85.19 / $147.30	Professional	26	$80.20	$85.19	$147.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.32 / $202.41 / $368.50	Professional	TC	$176.32	$202.41	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.52 / $61.52 / $61.52	Professional	26	$61.52	$61.52	$61.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.49 / $431.84 / $670.97	Professional		$339.49	$431.84	$670.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.08 / $93.21 / $134.10	Professional	26	$79.08	$93.21	$134.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.87 / $335.83 / $516.82	Professional	TC	$251.87	$335.83	$516.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $125.25 / $334.29	Professional		$87.11	$125.25	$334.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.08 / $617.52 / $1,088.05	Professional		$321.08	$617.52	$1,088.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.70 / $121.67 / $196.86	Professional	26	$75.70	$121.67	$196.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.27 / $515.97 / $918.80	Professional	TC	$224.27	$515.97	$918.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $314.84	Professional		$32.34	$32.34	$314.84
United Facility/Professional Professional Modifier Low / Median / High Price $299.68 / $538.12 / $648.64	Professional		$299.68	$538.12	$648.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.67 / $93.20 / $127.95	Professional	26	$75.67	$93.20	$127.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.02 / $325.19 / $570.80	Professional	TC	$203.02	$325.19	$570.80