Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $91.20 / $165.96	Facility	26	$85.11	$91.20	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $316.23 / $537.03	Professional		$245.47	$316.23	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $288.40	Professional	26	$79.43	$102.33	$288.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $173.78 / $173.78	Professional	50	$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $389.05	Professional	TC	$162.18	$218.78	$389.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $208.93	Professional	26	$83.18	$117.49	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $363.08 / $562.34	Professional		$331.13	$363.08	$562.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $134.90	Professional	26	$79.43	$83.18	$134.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $489.78 / $537.03 / $851.14	Professional	50	$489.78	$537.03	$851.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $275.42 / $436.52	Professional	TC	$234.42	$275.42	$436.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $131.83	Professional		$81.28	$112.20	$131.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $102.33 / $144.54	Facility	26	$21.88	$102.33	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $616.60 / $1,698.24	Professional		$346.74	$616.60	$1,698.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $151.36 / $457.09	Professional	26	$87.10	$151.36	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $489.78 / $1,380.38	Professional	TC	$245.47	$489.78	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $204.17	Professional		$32.36	$33.11	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $457.09 / $645.65	Professional		$323.59	$457.09	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $95.50 / $162.18	Professional	26	$83.18	$95.50	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $363.08 / $501.19	Professional	TC	$229.09	$363.08	$501.19