Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.90 / $100.90 / $177.72	Facility	26	$100.90	$100.90	$177.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.74 / $393.25 / $605.13	Professional		$362.74	$393.25	$605.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.82 / $100.90 / $145.19	Professional	26	$91.82	$100.90	$145.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.62 / $302.52 / $477.37	Professional	TC	$265.62	$302.52	$477.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $114.91 / $122.45 / $130.72	Professional	26	$114.91	$122.45	$130.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.85 / $364.53 / $539.25	Professional		$309.85	$364.53	$539.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.63 / $92.51 / $138.04	Professional	26	$78.63	$92.51	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.22 / $272.02 / $407.37	Professional	TC	$231.22	$272.02	$407.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.65 / $195.92 / $522.70	Professional		$112.65	$195.92	$522.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $435.36 / $600.54 / $871.49	Professional		$435.36	$600.54	$871.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.75 / $148.94 / $224.56	Professional	26	$109.75	$148.94	$224.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $325.62 / $460.11 / $662.76	Professional	TC	$325.62	$460.11	$662.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $385.84	Professional		$32.34	$32.34	$385.84
United Facility/Professional Professional Modifier Low / Median / High Price $382.51 / $471.25 / $617.51	Professional		$382.51	$471.25	$617.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.67 / $111.47 / $157.74	Professional	26	$95.67	$111.47	$157.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $290.30 / $353.96 / $578.40	Professional	TC	$290.30	$353.96	$578.40