Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $125.89 / $194.98	Facility	26	$104.71	$125.89	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $2,041.74	Professional		$309.03	$446.68	$2,041.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $144.54 / $380.19	Professional	26	$95.50	$144.54	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $263.03 / $446.68	Professional	TC	$208.93	$263.03	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $758.58	Professional		$251.19	$316.23	$758.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $112.20 / $204.17	Professional	26	$81.28	$112.20	$204.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $229.09 / $426.58	Professional	TC	$223.87	$229.09	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $407.38	Professional		$295.12	$295.12	$407.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $123.03	Professional	26	$91.20	$91.20	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $275.42	Professional	TC	$204.17	$204.17	$275.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $234.42 / $407.38	Professional		$112.20	$234.42	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $125.89 / $177.83	Facility	26	$26.92	$125.89	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $602.56 / $1,621.81	Professional		$354.81	$602.56	$1,621.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $186.21 / $512.86	Professional	26	$102.33	$186.21	$512.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $436.52 / $1,122.02	Professional	TC	$245.47	$436.52	$1,122.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $302.00	Professional		$32.36	$33.11	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $741.31 / $1,047.13	Professional		$363.08	$741.31	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $102.33 / $165.96	Professional	26	$77.62	$102.33	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $588.84 / $954.99	Professional	TC	$251.19	$588.84	$954.99