Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.15 / $90.62 / $159.63	Facility	26	$84.15	$90.62	$159.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.45 / $345.94 / $857.65	Professional		$289.45	$345.94	$857.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.01 / $111.74 / $317.79	Professional	26	$81.01	$111.74	$317.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $205.31 / $260.57 / $418.13	Professional	TC	$205.31	$260.57	$418.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.58 / $296.23 / $402.12	Professional		$221.58	$296.23	$402.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $87.25 / $104.72	Professional	26	$64.09	$87.25	$104.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $187.53 / $187.53 / $187.53	Professional	TC	$187.53	$187.53	$187.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $262.05 / $286.52 / $436.78	Professional		$262.05	$286.52	$436.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.31 / $92.85 / $138.59	Professional	26	$74.31	$92.85	$138.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.89 / $199.74 / $298.17	Professional	TC	$178.89	$199.74	$298.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.83 / $215.66 / $375.31	Professional		$89.83	$215.66	$375.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $98.40	Facility	26	$98.40	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.63 / $438.75 / $775.49	Professional		$291.63	$438.75	$775.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.45 / $124.26 / $202.86	Professional	26	$80.45	$124.26	$202.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $206.51 / $320.05 / $572.63	Professional	TC	$206.51	$320.05	$572.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $308.88	Professional		$32.34	$32.34	$308.88
United Facility/Professional Professional Modifier Low / Median / High Price $298.58 / $341.28 / $504.32	Professional		$298.58	$341.28	$504.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.70 / $97.89 / $142.07	Professional	26	$85.70	$97.89	$142.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.05 / $243.91 / $359.67	Professional	TC	$217.05	$243.91	$359.67