Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $144.54 / $144.54	Facility	26	$141.25	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $302.00 / $446.68	Professional		$251.19	$302.00	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $162.18 / $501.19	Professional	26	$134.90	$162.18	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $138.04 / $204.17	Professional	TC	$114.82	$138.04	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $158.49 / $363.08	Professional	26	$114.82	$158.49	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $371.54	Professional		$223.87	$223.87	$371.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $194.98	Professional	26	$123.03	$123.03	$194.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $102.33 / $169.82	Professional	TC	$100.00	$102.33	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $194.98	Professional		$128.82	$162.18	$194.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $173.78 / $251.19	Facility	26	$37.15	$173.78	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $1,380.38	Professional		$281.84	$426.58	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $281.84 / $724.44	Professional	26	$158.49	$281.84	$724.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $234.42 / $645.65	Professional	TC	$134.90	$234.42	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $295.12	Professional		$32.36	$33.11	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $295.12 / $436.52	Professional		$257.04	$295.12	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $245.47	Professional	26	$138.04	$162.18	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $138.04 / $199.53	Professional	TC	$117.49	$138.04	$199.53