Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $281.84 / $407.38	Facility	26	$208.93	$281.84	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $812.83	Professional		$426.58	$489.78	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $269.15 / $537.03	Professional	26	$208.93	$269.15	$537.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $251.19 / $398.11	Professional	TC	$208.93	$251.19	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $239.88 / $436.52	Professional	26	$181.97	$239.88	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $501.19 / $812.83	Professional		$478.63	$501.19	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $239.88 / $380.19	Professional	26	$223.87	$239.88	$380.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $257.04 / $426.58	Professional	TC	$234.42	$257.04	$426.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $295.12 / $575.44	Professional		$234.42	$295.12	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $257.04 / $371.54	Facility	26	$54.95	$257.04	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $870.96 / $2,238.72	Professional		$489.78	$870.96	$2,238.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $416.87 / $1,071.52	Professional	26	$239.88	$416.87	$1,071.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $436.52 / $1,174.90	Professional	TC	$251.19	$436.52	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $741.31	Professional		$426.58	$501.19	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $239.88 / $363.08	Professional	26	$208.93	$239.88	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $269.15 / $389.05	Professional	TC	$223.87	$269.15	$389.05