Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.65 / $230.93 / $381.07	Facility	26	$216.65	$230.93	$381.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.57 / $469.46 / $788.94	Professional		$422.57	$469.46	$788.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $197.16 / $216.65 / $376.79	Professional	26	$197.16	$216.65	$376.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $211.81 / $239.11 / $411.74	Professional	TC	$211.81	$239.11	$411.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $430.61 / $430.61 / $430.61	Professional		$430.61	$430.61	$430.61
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 $405.08 / $497.79 / $633.78	Professional		$405.08	$497.79	$633.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $204.79 / $240.94 / $306.75	Professional	26	$204.79	$240.94	$306.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $192.63 / $256.85 / $354.60	Professional	TC	$192.63	$256.85	$354.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $232.89 / $296.73 / $591.04	Professional		$232.89	$296.73	$591.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.39 / $256.39 / $256.39	Facility	26	$256.39	$256.39	$256.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.97 / $667.40 / $1,061.09	Professional		$484.97	$667.40	$1,061.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $236.76 / $321.94 / $479.38	Professional	26	$236.76	$321.94	$479.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.21 / $358.21 / $581.73	Professional	TC	$248.21	$358.21	$581.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $464.39	Professional		$32.34	$32.34	$464.39
United Facility/Professional Professional Modifier Low / Median / High Price $431.45 / $500.14 / $683.09	Professional		$431.45	$500.14	$683.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $211.09 / $241.69 / $333.54	Professional	26	$211.09	$241.69	$333.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.32 / $267.04 / $347.07	Professional	TC	$224.32	$267.04	$347.07