Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.87 / $108.42 / $192.35	Facility	26	$100.87	$108.42	$192.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $360.31 / $512.36 / $837.86	Professional		$360.31	$512.36	$837.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.25 / $106.82 / $366.75	Professional	26	$91.25	$106.82	$366.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.44 / $408.61 / $562.75	Professional	TC	$259.44	$408.61	$562.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.27 / $337.17 / $337.17	Professional		$251.27	$337.17	$337.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.93 / $102.90 / $121.05	Professional	26	$76.93	$102.90	$121.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $240.32 / $240.32 / $240.32	Professional	TC	$240.32	$240.32	$240.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $418.16 / $498.67 / $621.04	Professional		$418.16	$498.67	$621.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.97 / $117.80 / $147.61	Professional	26	$100.97	$117.80	$147.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $318.02 / $385.38 / $484.59	Professional	TC	$318.02	$385.38	$484.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.02 / $276.37 / $472.04	Professional		$108.02	$276.37	$472.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.52 / $118.52 / $118.52	Facility	26	$118.52	$118.52	$118.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $642.12 / $1,212.11	Professional		$400.00	$642.12	$1,212.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.59 / $147.63 / $245.42	Professional	26	$95.59	$147.63	$245.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $286.77 / $485.34 / $903.25	Professional	TC	$286.77	$485.34	$903.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $438.32	Professional		$32.34	$32.34	$438.32
United Facility/Professional Professional Modifier Low / Median / High Price $379.07 / $537.57 / $729.80	Professional		$379.07	$537.57	$729.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.73 / $117.26 / $168.93	Professional	26	$99.73	$117.26	$168.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.75 / $416.18 / $542.92	Professional	TC	$261.75	$416.18	$542.92