Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.17 / $105.51 / $198.35	Facility	26	$101.17	$105.51	$198.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.33 / $475.00 / $1,133.43	Professional		$323.33	$475.00	$1,133.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.17 / $140.00 / $444.62	Professional	26	$101.17	$140.00	$444.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $222.17 / $335.00 / $828.53	Professional	TC	$222.17	$335.00	$828.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.58 / $248.01 / $475.28	Professional		$223.58	$248.01	$475.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.69 / $96.61 / $126.26	Professional	26	$77.69	$96.61	$126.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $396.13 / $529.76 / $816.34	Professional		$396.13	$529.76	$816.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.00 / $120.93 / $174.70	Professional	26	$98.00	$120.93	$174.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $405.19 / $592.94	Professional	TC	$285.00	$405.19	$592.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.30 / $233.94 / $420.77	Professional		$108.30	$233.94	$420.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $404.73 / $889.99 / $1,620.00	Professional		$404.73	$889.99	$1,620.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.65 / $157.50 / $254.91	Professional	26	$98.65	$157.50	$254.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.43 / $758.47 / $1,435.20	Professional	TC	$281.43	$758.47	$1,435.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $683.09	Professional		$32.34	$32.34	$683.09
United Facility/Professional Professional Modifier Low / Median / High Price $356.11 / $590.09 / $1,060.60	Professional		$356.11	$590.09	$1,060.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.86 / $117.31 / $161.43	Professional	26	$96.86	$117.31	$161.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.79 / $428.21 / $894.08	Professional	TC	$255.79	$428.21	$894.08