Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.91 / $79.91 / $105.90	Facility	26	$79.91	$79.91	$105.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.47 / $383.86 / $549.21	Professional		$288.47	$383.86	$549.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.91 / $87.45 / $146.36	Professional	26	$79.91	$87.45	$146.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.56 / $275.89 / $424.84	Professional	TC	$208.56	$275.89	$424.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.04 / $75.70 / $123.04	Professional	26	$67.04	$75.70	$123.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.94 / $441.87 / $741.33	Professional		$348.94	$441.87	$741.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.95 / $82.50 / $135.09	Professional	26	$64.95	$82.50	$135.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.14 / $356.00 / $587.16	Professional	TC	$275.14	$356.00	$587.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.30 / $125.25 / $398.13	Professional		$87.30	$125.25	$398.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.37 / $682.27 / $1,179.15	Professional		$361.37	$682.27	$1,179.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.70 / $121.22 / $196.14	Professional	26	$75.70	$121.22	$196.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.55 / $545.79 / $1,009.91	Professional	TC	$264.55	$545.79	$1,009.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $369.29	Professional		$32.34	$32.34	$369.29
United Facility/Professional Professional Modifier Low / Median / High Price $319.29 / $498.05 / $732.65	Professional		$319.29	$498.05	$732.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.48 / $92.85 / $124.30	Professional	26	$75.48	$92.85	$124.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.55 / $463.63 / $607.59	Professional	TC	$252.55	$463.63	$607.59