Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.65 / $283.27 / $380.54	Facility	26	$216.65	$283.27	$380.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $432.97 / $504.95 / $846.47	Professional		$432.97	$504.95	$846.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $216.65 / $358.72	Professional	26	$198.28	$216.65	$358.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.53 / $306.66 / $503.33	Professional	TC	$224.53	$306.66	$503.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $431.24 / $431.24 / $431.24	Professional		$431.24	$431.24	$431.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $168.36 / $273.58 / $294.63	Professional	26	$168.36	$273.58	$294.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $409.57 / $531.04 / $1,608.37	Professional		$409.57	$531.04	$1,608.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $217.58 / $255.98 / $344.90	Professional	26	$217.58	$255.98	$344.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $203.79 / $261.02 / $1,442.28	Professional	TC	$203.79	$261.02	$1,442.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $231.50 / $305.14 / $603.74	Professional		$231.50	$305.14	$603.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $604.70 / $872.89 / $2,421.17	Professional		$604.70	$872.89	$2,421.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $221.87 / $331.50 / $460.68	Professional	26	$221.87	$331.50	$460.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $311.68 / $655.79 / $1,824.99	Professional	TC	$311.68	$655.79	$1,824.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $474.36	Professional		$32.34	$32.34	$474.36
United Facility/Professional Professional Modifier Low / Median / High Price $445.80 / $637.99 / $1,223.91	Professional		$445.80	$637.99	$1,223.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $200.12 / $241.34 / $340.75	Professional	26	$200.12	$241.34	$340.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.84 / $348.08 / $893.64	Professional	TC	$224.84	$348.08	$893.64