Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $104.71 / $158.49	Facility	26	$100.00	$104.71	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $467.74 / $933.25	Professional		$338.84	$467.74	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $138.04 / $346.74	Professional	26	$91.20	$138.04	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $331.13 / $537.03	Professional	TC	$229.09	$331.13	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $190.55	Professional	26	$79.43	$112.20	$190.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	TC	$257.04	$257.04	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $501.19 / $691.83	Professional		$467.74	$501.19	$691.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $147.91	Professional	26	$100.00	$117.49	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $389.05 / $537.03	Professional	TC	$331.13	$389.05	$537.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $263.03 / $457.09	Professional		$107.15	$263.03	$457.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $117.49 / $169.82	Facility	26	$25.70	$117.49	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $724.44 / $1,819.70	Professional		$380.19	$724.44	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $173.78 / $478.63	Professional	26	$102.33	$173.78	$478.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $575.44 / $1,412.54	Professional	TC	$275.42	$575.44	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $537.03 / $741.31	Professional		$354.81	$537.03	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $114.82 / $190.55	Professional	26	$100.00	$114.82	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $416.87 / $588.84	Professional	TC	$257.04	$416.87	$588.84