Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $107.15 / $138.04	Facility	26	$75.86	$107.15	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $457.09 / $1,288.25	Professional		$295.12	$457.09	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $120.23 / $245.47	Professional	26	$75.86	$120.23	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $645.65	Professional	TC	$223.87	$338.84	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $724.44	Professional		$213.80	$295.12	$724.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $100.00	Professional	26	$57.54	$72.44	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	TC	$181.97	$181.97	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $776.25	Professional		$389.05	$407.38	$776.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $87.10 / $123.03	Professional	26	$72.44	$87.10	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $309.03 / $645.65	Professional	TC	$295.12	$309.03	$645.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $223.87 / $371.54	Professional		$79.43	$223.87	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $707.95 / $2,511.89	Professional		$371.54	$707.95	$2,511.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $138.04 / $380.19	Professional	26	$74.13	$138.04	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $588.84 / $1,659.59	Professional	TC	$281.84	$588.84	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $691.83	Professional		$331.13	$512.86	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $83.18 / $120.23	Professional	26	$72.44	$83.18	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $436.52 / $588.84	Professional	TC	$251.19	$436.52	$588.84