Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.58 / $118.84 / $161.09	Facility	26	$82.58	$118.84	$161.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $319.83 / $431.47 / $630.00	Professional		$319.83	$431.47	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.58 / $111.14 / $204.14	Professional	26	$82.58	$111.14	$204.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.26 / $322.14 / $453.84	Professional	TC	$237.26	$322.14	$453.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.87 / $98.46 / $98.46	Professional	26	$63.87	$98.46	$98.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $364.97 / $429.37 / $659.61	Professional		$364.97	$429.37	$659.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.32 / $99.21 / $150.41	Professional	26	$84.32	$99.21	$150.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $280.64 / $330.17 / $500.92	Professional	TC	$280.64	$330.17	$500.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.39 / $129.97 / $442.97	Professional		$90.39	$129.97	$442.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.08 / $624.53 / $1,046.52	Professional		$402.08	$624.53	$1,046.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.81 / $133.10 / $203.37	Professional	26	$78.81	$133.10	$203.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $301.95 / $495.74 / $870.32	Professional	TC	$301.95	$495.74	$870.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $387.53	Professional		$32.34	$32.34	$387.53
United Facility/Professional Professional Modifier Low / Median / High Price $351.17 / $477.66 / $690.44	Professional		$351.17	$477.66	$690.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.64 / $94.27 / $131.72	Professional	26	$78.64	$94.27	$131.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $270.86 / $386.80 / $564.44	Professional	TC	$270.86	$386.80	$564.44