Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $302.00 / $363.08 / $501.19	Facility	26	$302.00	$363.08	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,230.27 / $1,862.09	Professional		$1,023.29	$1,230.27	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $371.54 / $645.65	Professional	26	$269.15	$371.54	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $870.96 / $1,318.26	Professional	TC	$724.44	$870.96	$1,318.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $331.13 / $407.38	Professional	26	$245.47	$331.13	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $891.25 / $2,344.23	Professional		$575.44	$891.25	$2,344.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $426.58 / $660.69	Professional	26	$309.03	$426.58	$660.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $1,000.00 / $1,548.82	Professional	TC	$588.84	$1,000.00	$1,548.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $691.83 / $1,202.26	Professional		$275.42	$691.83	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,348.96 / $2,951.21	Professional		$1,122.02	$1,348.96	$2,951.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $416.87 / $891.25	Professional	26	$302.00	$416.87	$891.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $812.83 / $977.24 / $2,089.30	Professional	TC	$812.83	$977.24	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,288.25 / $2,089.30	Professional		$933.25	$1,288.25	$2,089.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $389.05 / $602.56	Professional	26	$269.15	$389.05	$602.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $891.25 / $1,513.56	Professional	TC	$676.08	$891.25	$1,513.56