Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.54 / $88.65 / $298.33	Facility	26	$80.54	$88.65	$298.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.51 / $213.75 / $481.17	Professional		$175.51	$213.75	$481.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.33 / $88.65 / $277.20	Professional	26	$76.33	$88.65	$277.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.96 / $132.61 / $257.57	Professional	TC	$94.96	$132.61	$257.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.75 / $183.01 / $248.43	Professional		$135.75	$183.01	$248.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.06 / $86.25 / $99.48	Professional	26	$61.06	$86.25	$99.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $89.10 / $89.10 / $104.51	Professional	TC	$89.10	$89.10	$104.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.60 / $210.26 / $302.01	Professional		$175.60	$210.26	$302.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.89 / $82.77 / $132.69	Professional	26	$70.89	$82.77	$132.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.88 / $123.82 / $174.57	Professional	TC	$103.88	$123.82	$174.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.17 / $115.83 / $231.87	Professional		$84.17	$115.83	$231.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.15 / $94.15 / $94.15	Facility	26	$94.15	$94.15	$94.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.99 / $285.70 / $496.56	Professional		$184.99	$285.70	$496.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.73 / $118.52 / $194.08	Professional	26	$76.73	$118.52	$194.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.24 / $164.59 / $302.48	Professional	TC	$108.24	$164.59	$302.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $196.56	Professional		$32.34	$32.34	$196.56
United Facility/Professional Professional Modifier Low / Median / High Price $177.17 / $218.14 / $325.45	Professional		$177.17	$218.14	$325.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.70 / $95.08 / $135.54	Professional	26	$80.70	$95.08	$135.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.21 / $126.61 / $189.92	Professional	TC	$99.21	$126.61	$189.92