Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.51 / $70.67 / $132.05	Facility	26	$67.51	$70.67	$132.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.62 / $349.79 / $733.72	Professional		$187.62	$349.79	$733.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.51 / $113.05 / $322.00	Professional	26	$67.51	$113.05	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.11 / $244.98 / $448.88	Professional	TC	$120.11	$244.98	$448.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.75 / $149.75 / $149.75	Professional		$149.75	$149.75	$149.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.07 / $63.83 / $83.25	Professional	26	$51.07	$63.83	$83.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.58 / $358.11 / $526.13	Professional		$257.58	$358.11	$526.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.80 / $79.50 / $113.61	Professional	26	$66.80	$79.50	$113.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.45 / $268.87 / $400.00	Professional	TC	$191.45	$268.87	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $133.43 / $244.58	Professional		$70.76	$133.43	$244.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.64 / $524.86 / $893.36	Professional		$234.64	$524.86	$893.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.74 / $107.63 / $165.36	Professional	26	$63.74	$107.63	$165.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.71 / $417.91 / $749.12	Professional	TC	$152.71	$417.91	$749.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $314.84	Professional		$32.34	$32.34	$314.84
United Facility/Professional Professional Modifier Low / Median / High Price $211.37 / $343.22 / $553.04	Professional		$211.37	$343.22	$553.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.82 / $80.93 / $107.49	Professional	26	$63.82	$80.93	$107.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.37 / $215.23 / $472.93	Professional	TC	$138.37	$215.23	$472.93