Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.47 / $119.02 / $195.07	Facility	26	$99.47	$119.02	$195.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.27 / $475.00 / $1,123.89	Professional		$369.27	$475.00	$1,123.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.47 / $140.00 / $318.06	Professional	26	$99.47	$140.00	$318.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.80 / $335.00 / $887.84	Professional	TC	$269.80	$335.00	$887.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.39 / $299.39 / $299.39	Professional		$299.39	$299.39	$299.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.75 / $76.17 / $119.03	Professional	26	$75.75	$76.17	$119.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $369.39 / $493.08 / $727.69	Professional		$369.39	$493.08	$727.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.20 / $115.21 / $164.28	Professional	26	$90.20	$115.21	$164.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $272.63 / $374.41 / $578.09	Professional	TC	$272.63	$374.41	$578.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $152.35 / $509.96	Professional		$109.50	$152.35	$509.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $116.87	Facility	26	$116.87	$116.87	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $462.88 / $861.31 / $1,588.20	Professional		$462.88	$861.31	$1,588.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.68 / $150.68 / $243.65	Professional	26	$93.68	$150.68	$243.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $341.66 / $720.85 / $1,411.80	Professional	TC	$341.66	$720.85	$1,411.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $681.53	Professional		$32.34	$32.34	$681.53
United Facility/Professional Professional Modifier Low / Median / High Price $410.00 / $642.67 / $1,020.13	Professional		$410.00	$642.67	$1,020.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.45 / $115.20 / $153.59	Professional	26	$95.45	$115.20	$153.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.54 / $600.70 / $863.83	Professional	TC	$308.54	$600.70	$863.83