Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.60 / $65.76 / $122.93	Facility	26	$62.60	$65.76	$122.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.73 / $475.00 / $1,686.10	Professional		$266.73	$475.00	$1,686.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.60 / $99.22 / $191.45	Professional	26	$62.60	$99.22	$191.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.12 / $335.00 / $561.04	Professional	TC	$204.12	$335.00	$561.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $220.25 / $227.33 / $234.02	Professional		$220.25	$227.33	$234.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $48.33 / $74.53	Professional	26	$47.62	$48.33	$74.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.26 / $365.93 / $477.92	Professional		$308.26	$365.93	$477.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $72.51 / $102.34	Professional	26	$56.20	$72.51	$102.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.68 / $291.24 / $400.00	Professional	TC	$245.68	$291.24	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $236.56 / $371.46	Professional		$66.45	$236.56	$371.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.03 / $569.22 / $980.33	Professional		$362.03	$569.22	$980.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.49 / $94.70 / $152.76	Professional	26	$58.49	$94.70	$152.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.64 / $491.74 / $849.00	Professional	TC	$285.64	$491.74	$849.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $344.93	Professional		$32.34	$32.34	$344.93
United Facility/Professional Professional Modifier Low / Median / High Price $318.47 / $448.18 / $642.39	Professional		$318.47	$448.18	$642.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.66 / $72.45 / $99.89	Professional	26	$58.66	$72.45	$99.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.50 / $358.12 / $520.85	Professional	TC	$244.50	$358.12	$520.85