Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.32 / $98.32 / $127.01	Facility	26	$98.32	$98.32	$127.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $314.27 / $449.47	Professional		$293.74	$314.27	$449.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $98.32 / $127.01	Professional	26	$89.57	$98.32	$127.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $215.96 / $325.23	Professional	TC	$204.15	$215.96	$325.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.62 / $76.62 / $119.73	Professional	26	$76.62	$76.62	$119.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.35 / $300.08 / $444.75	Professional		$291.35	$300.08	$444.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.45 / $100.37 / $132.44	Professional	26	$97.45	$100.37	$132.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $193.90 / $199.72 / $300.30	Professional	TC	$193.90	$199.72	$300.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.15 / $191.56 / $445.84	Professional		$110.15	$191.56	$445.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.54 / $116.54 / $116.54	Facility	26	$116.54	$116.54	$116.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.33 / $439.23 / $658.49	Professional		$328.33	$439.23	$658.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.79 / $146.47 / $220.70	Professional	26	$107.79	$146.47	$220.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.10 / $296.55 / $437.79	Professional	TC	$216.10	$296.55	$437.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $336.03	Professional		$32.34	$32.34	$336.03
United Facility/Professional Professional Modifier Low / Median / High Price $289.95 / $352.72 / $462.90	Professional		$289.95	$352.72	$462.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.13 / $116.50 / $152.18	Professional	26	$94.13	$116.50	$152.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.33 / $221.54 / $310.72	Professional	TC	$196.33	$221.54	$310.72