Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $134.90 / $147.91	Facility	26	$85.11	$134.90	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $323.59 / $1,096.48	Professional		$229.09	$323.59	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $117.49 / $389.05	Professional	26	$77.62	$117.49	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $173.78 / $302.00	Professional	TC	$144.54	$173.78	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $549.54	Professional		$194.98	$257.04	$549.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $154.88	Professional	26	$81.28	$100.00	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $380.19	Professional		$204.17	$239.88	$380.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $128.82	Professional	26	$77.62	$91.20	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $144.54 / $229.09	Professional	TC	$123.03	$144.54	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $144.54 / $263.03	Professional		$81.28	$144.54	$263.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $131.83	Facility	26	$19.95	$93.33	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $363.08 / $1,071.52	Professional		$218.78	$363.08	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $134.90 / $380.19	Professional	26	$85.11	$134.90	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $234.42 / $691.83	Professional	TC	$147.91	$234.42	$691.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $426.58	Professional		$218.78	$288.40	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $112.20 / $165.96	Professional	26	$79.43	$112.20	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $177.83 / $269.15	Professional	TC	$131.83	$177.83	$269.15