Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.29 / $69.93 / $122.71	Facility	26	$64.29	$69.93	$122.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.98 / $366.58 / $677.13	Professional		$221.98	$366.58	$677.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.24 / $69.98 / $148.26	Professional	26	$61.24	$69.98	$148.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.68 / $306.18 / $541.83	Professional	TC	$157.68	$306.18	$541.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.17 / $242.01 / $325.94	Professional		$190.17	$242.01	$325.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.91 / $57.74 / $76.55	Professional	26	$48.91	$57.74	$76.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.13 / $283.68 / $431.29	Professional		$241.13	$283.68	$431.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.78 / $77.38 / $117.47	Professional	26	$65.78	$77.38	$117.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.35 / $206.30 / $333.70	Professional	TC	$175.35	$206.30	$333.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $193.48 / $321.29	Professional		$70.31	$193.48	$321.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.72 / $471.24 / $829.89	Professional		$309.72	$471.24	$829.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.23 / $103.42 / $185.28	Professional	26	$61.23	$103.42	$185.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.41 / $361.14 / $693.02	Professional	TC	$228.41	$361.14	$693.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $282.48	Professional		$32.34	$32.34	$282.48
United Facility/Professional Professional Modifier Low / Median / High Price $247.52 / $363.18 / $524.66	Professional		$247.52	$363.18	$524.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.03 / $72.45 / $107.73	Professional	26	$61.03	$72.45	$107.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.99 / $292.55 / $418.60	Professional	TC	$183.99	$292.55	$418.60