Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $68.12 / $88.40	Facility	26	$43.62	$68.12	$88.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.24 / $319.62 / $357.47	Professional		$287.24	$319.62	$357.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.62 / $48.31 / $54.99	Professional	26	$43.62	$48.31	$54.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.62 / $271.31 / $308.92	Professional	TC	$243.62	$271.31	$308.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $249.43 / $249.43 / $249.43	Professional		$249.43	$249.43	$249.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.28 / $64.92 / $77.75	Professional	26	$60.28	$64.92	$77.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.11 / $286.01 / $445.90	Professional		$243.11	$286.01	$445.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.46 / $57.02 / $71.09	Professional	26	$48.46	$57.02	$71.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.64 / $227.32 / $362.90	Professional	TC	$194.64	$227.32	$362.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.33 / $76.51 / $491.42	Professional		$53.33	$76.51	$491.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.28 / $57.28 / $57.28	Facility	26	$57.28	$57.28	$57.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.22 / $533.79 / $1,580.91	Professional		$328.22	$533.79	$1,580.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.15 / $83.99 / $253.39	Professional	26	$53.15	$83.99	$253.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.17 / $433.24 / $1,350.18	Professional	TC	$269.17	$433.24	$1,350.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $321.29	Professional		$32.34	$32.34	$321.29
United Facility/Professional Professional Modifier Low / Median / High Price $285.66 / $408.13 / $499.15	Professional		$285.66	$408.13	$499.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.88 / $58.07 / $75.59	Professional	26	$47.88	$58.07	$75.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $237.78 / $334.42 / $426.34	Professional	TC	$237.78	$334.42	$426.34