Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.60 / $113.84 / $201.52	Facility	26	$110.60	$113.84	$201.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.79 / $217.58 / $380.51	Professional		$203.79	$217.58	$380.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.23 / $114.96 / $176.08	Professional	26	$106.23	$114.96	$176.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.19 / $101.95 / $220.00	Professional	TC	$93.19	$101.95	$220.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $198.01 / $198.01 / $198.01	Professional	26	$198.01	$198.01	$198.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.88 / $301.58 / $490.41	Professional		$248.88	$301.58	$490.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.19 / $122.58 / $183.28	Professional	26	$104.19	$122.58	$183.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.35 / $179.01 / $357.96	Professional	TC	$130.35	$179.01	$357.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.15 / $148.61 / $212.30	Professional		$106.15	$148.61	$212.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.26 / $567.85 / $1,049.98	Professional		$344.26	$567.85	$1,049.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.39 / $154.68 / $267.20	Professional	26	$95.39	$154.68	$267.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $240.33 / $416.75 / $673.58	Professional	TC	$240.33	$416.75	$673.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $259.33	Professional		$32.34	$32.34	$259.33
United Facility/Professional Professional Modifier Low / Median / High Price $371.27 / $490.46 / $711.28	Professional		$371.27	$490.46	$711.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.30 / $126.23 / $181.64	Professional	26	$103.30	$126.23	$181.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.97 / $362.34 / $543.51	Professional	TC	$267.97	$362.34	$543.51