Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.85 / $120.18 / $165.43	Facility	26	$86.85	$120.18	$165.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.24 / $384.67 / $624.48	Professional		$244.24	$384.67	$624.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $90.69 / $202.33	Professional	26	$82.39	$90.69	$202.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.38 / $300.52 / $508.96	Professional	TC	$157.38	$300.52	$508.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.40 / $82.71 / $103.91	Professional	26	$67.40	$82.71	$103.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.24 / $348.80 / $566.23	Professional		$266.24	$348.80	$566.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.15 / $82.54 / $129.12	Professional	26	$70.15	$82.54	$129.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $399.36 / $523.20 / $849.35	Professional	50	$399.36	$523.20	$849.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $197.42 / $272.00 / $387.03	Professional	TC	$197.42	$272.00	$387.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.60 / $133.01 / $424.12	Professional		$95.60	$133.01	$424.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.27 / $537.75 / $972.92	Professional		$381.27	$537.75	$972.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.19 / $131.22 / $215.86	Professional	26	$83.19	$131.22	$215.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $276.44 / $415.45 / $757.06	Professional	TC	$276.44	$415.45	$757.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $256.26	Professional		$32.34	$32.34	$256.26
United Facility/Professional Professional Modifier Low / Median / High Price $316.72 / $440.14 / $636.46	Professional		$316.72	$440.14	$636.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.38 / $100.70 / $144.00	Professional	26	$83.38	$100.70	$144.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.40 / $360.29 / $484.81	Professional	TC	$232.40	$360.29	$484.81