Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $403.85 / $502.61 / $709.41	Facility	26	$403.85	$502.61	$709.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,637.05 / $1,889.42 / $3,143.85	Professional		$1,637.05	$1,889.42	$3,143.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $367.50 / $403.85 / $695.31	Professional	26	$367.50	$403.85	$695.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,249.39 / $1,502.32 / $2,530.81	Professional	TC	$1,249.39	$1,502.32	$2,530.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,641.48 / $1,641.48 / $1,641.48	Professional		$1,641.48	$1,641.48	$1,641.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $314.19 / $510.56 / $549.84	Professional	26	$314.19	$510.56	$549.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,462.82 / $1,772.60 / $2,729.12	Professional		$1,462.82	$1,772.60	$2,729.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $379.93 / $446.98 / $626.00	Professional	26	$379.93	$446.98	$626.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,093.96 / $1,325.62 / $2,073.03	Professional	TC	$1,093.96	$1,325.62	$2,073.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $451.65 / $1,399.03 / $2,269.10	Professional		$451.65	$1,399.03	$2,269.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $477.29 / $477.29 / $477.29	Facility	26	$477.29	$477.29	$477.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,761.03 / $2,651.76 / $5,660.35	Professional		$1,761.03	$2,651.76	$5,660.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $403.62 / $610.23 / $1,217.35	Professional	26	$403.62	$610.23	$1,217.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,357.42 / $1,940.69 / $2,902.46	Professional	TC	$1,357.42	$1,940.69	$2,902.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,770.22	Professional		$32.34	$32.34	$1,770.22
United Facility/Professional Professional Modifier Low / Median / High Price $1,565.01 / $1,959.71 / $2,735.71	Professional		$1,565.01	$1,959.71	$2,735.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $364.16 / $456.43 / $621.02	Professional	26	$364.16	$456.43	$621.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,192.40 / $1,570.17 / $2,148.61	Professional	TC	$1,192.40	$1,570.17	$2,148.61