Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.67 / $113.54 / $241.61	Facility	26	$107.67	$113.54	$241.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.32 / $339.29 / $721.25	Professional		$298.32	$339.29	$721.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.21 / $118.23 / $220.53	Professional	26	$106.21	$118.23	$220.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $213.62 / $500.72	Professional	TC	$181.94	$213.62	$500.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $259.08 / $259.08 / $382.99	Professional		$259.08	$259.08	$382.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.54 / $181.66 / $181.66	Professional	26	$89.54	$181.66	$181.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $147.22 / $383.01	Professional		$134.40	$147.22	$383.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $113.06 / $179.56	Professional	26	$95.50	$113.06	$179.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.19 / $33.61 / $191.80	Professional	TC	$28.19	$33.61	$191.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $154.41 / $307.14 / $525.66	Professional		$154.41	$307.14	$525.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $251.40 / $251.40 / $251.40	Facility	26	$251.40	$251.40	$251.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.98 / $293.24 / $595.13	Professional		$193.98	$293.24	$595.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.94 / $143.66 / $257.88	Professional	26	$65.94	$143.66	$257.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.60 / $150.24 / $389.54	Professional	TC	$125.60	$150.24	$389.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $233.44 / $386.36 / $641.49	Professional		$233.44	$386.36	$641.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.38 / $148.51 / $282.20	Professional	26	$104.38	$148.51	$282.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.99 / $240.30 / $412.50	Professional	TC	$112.99	$240.30	$412.50