Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $97.72 / $123.03	Facility	26	$67.61	$97.72	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $371.54 / $1,288.25	Professional		$199.53	$371.54	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $120.23 / $354.81	Professional	26	$67.61	$120.23	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $251.19 / $562.34	Professional	TC	$131.83	$251.19	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $446.68	Professional		$151.36	$151.36	$446.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $128.82	Professional	26	$51.29	$72.44	$128.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	TC	$162.18	$162.18	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $724.44	Professional		$309.03	$363.08	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $81.28 / $123.03	Professional	26	$69.18	$81.28	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $562.34	Professional	TC	$223.87	$263.03	$562.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $128.82 / $234.42	Professional		$70.79	$128.82	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $77.62 / $112.20	Facility	26	$16.98	$77.62	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $602.56 / $2,137.96	Professional		$245.47	$602.56	$2,137.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $125.89 / $338.84	Professional	26	$67.61	$125.89	$338.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $467.74 / $1,412.54	Professional	TC	$151.36	$467.74	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $436.52 / $602.56	Professional		$204.17	$436.52	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $112.20	Professional	26	$64.57	$75.86	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $346.74 / $501.19	Professional	TC	$134.90	$346.74	$501.19