Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.19 / $96.51 / $139.13	Facility	26	$79.19	$96.51	$139.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.80 / $481.64 / $760.86	Professional		$395.80	$481.64	$760.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.87 / $79.19 / $130.69	Professional	26	$71.87	$79.19	$130.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $319.77 / $413.91 / $660.71	Professional	TC	$319.77	$413.91	$660.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $381.33 / $381.33 / $388.96	Professional		$381.33	$381.33	$388.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.30 / $99.62 / $107.28	Professional	26	$61.30	$99.62	$107.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.52 / $433.69 / $644.97	Professional		$354.52	$433.69	$644.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.04 / $87.11 / $121.84	Professional	26	$74.04	$87.11	$121.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $270.14 / $346.58 / $515.91	Professional	TC	$270.14	$346.58	$515.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.12 / $350.42 / $537.67	Professional		$88.12	$350.42	$537.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.59 / $93.59 / $93.59	Facility	26	$93.59	$93.59	$93.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.43 / $594.11 / $882.17	Professional		$428.43	$594.11	$882.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.80 / $117.77 / $162.19	Professional	26	$78.80	$117.77	$162.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $333.91 / $475.93 / $738.62	Professional	TC	$333.91	$475.93	$738.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $419.46	Professional		$32.34	$32.34	$419.46
United Facility/Professional Professional Modifier Low / Median / High Price $385.50 / $496.97 / $739.74	Professional		$385.50	$496.97	$739.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $85.17 / $122.13	Professional	26	$70.80	$85.17	$122.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $327.31 / $421.08 / $554.46	Professional	TC	$327.31	$421.08	$554.46