Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.18 / $131.60 / $194.47	Facility	26	$99.18	$131.60	$194.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.09 / $475.00 / $1,123.89	Professional		$368.09	$475.00	$1,123.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.18 / $140.00 / $322.00	Professional	26	$99.18	$140.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $268.91 / $335.00 / $713.08	Professional	TC	$268.91	$335.00	$713.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.08 / $281.08 / $281.08	Professional		$281.08	$281.08	$281.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.75 / $100.40 / $123.79	Professional	26	$75.75	$100.40	$123.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.63 / $494.50 / $726.20	Professional		$368.63	$494.50	$726.20
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 $273.66 / $375.83 / $579.23	Professional	TC	$273.66	$375.83	$579.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $281.26 / $475.69	Professional		$106.19	$281.26	$475.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $460.96 / $860.99 / $1,587.60	Professional		$460.96	$860.99	$1,587.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.96 / $150.68 / $242.93	Professional	26	$93.96	$150.68	$242.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $340.13 / $718.61 / $1,411.20	Professional	TC	$340.13	$718.61	$1,411.20
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 $410.16 / $598.66 / $1,033.19	Professional		$410.16	$598.66	$1,033.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.76 / $115.18 / $158.25	Professional	26	$93.76	$115.18	$158.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $303.31 / $453.22 / $893.78	Professional	TC	$303.31	$453.22	$893.78