Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.57 / $186.74 / $232.46	Facility	26	$118.57	$186.74	$232.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.84 / $475.00 / $1,020.82	Professional		$347.84	$475.00	$1,020.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.57 / $140.00 / $257.74	Professional	26	$118.57	$140.00	$257.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.27 / $335.00 / $455.74	Professional	TC	$229.27	$335.00	$455.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.47 / $289.47 / $289.47	Professional		$289.47	$289.47	$289.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $92.18 / $142.18 / $142.18	Professional	26	$92.18	$142.18	$142.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $378.09 / $444.82 / $764.98	Professional		$378.09	$444.82	$764.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.31 / $141.55 / $212.17	Professional	26	$120.31	$141.55	$212.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.77 / $303.27 / $584.41	Professional	TC	$257.77	$303.27	$584.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $130.43 / $249.56 / $450.39	Professional		$130.43	$249.56	$450.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.51 / $705.75 / $1,214.58	Professional		$431.51	$705.75	$1,214.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.61 / $177.69 / $296.81	Professional	26	$115.61	$177.69	$296.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.02 / $515.34 / $952.10	Professional	TC	$291.02	$515.34	$952.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $418.22	Professional		$32.34	$32.34	$418.22
United Facility/Professional Professional Modifier Low / Median / High Price $381.44 / $581.83 / $769.70	Professional		$381.44	$581.83	$769.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.37 / $140.38 / $188.30	Professional	26	$116.37	$140.38	$188.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $265.50 / $404.18 / $620.13	Professional	TC	$265.50	$404.18	$620.13