Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $293.58 / $313.75 / $566.51	Facility	26	$293.58	$313.75	$566.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,021.16 / $1,085.07 / $1,760.56	Professional		$1,021.16	$1,085.07	$1,760.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $269.17 / $318.36 / $536.49	Professional	26	$269.17	$318.36	$536.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $722.07 / $779.44 / $1,249.33	Professional	TC	$722.07	$779.44	$1,249.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $333.61 / $333.61 / $352.33	Professional	26	$333.61	$333.61	$352.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $761.71 / $896.14 / $1,343.24	Professional		$761.71	$896.14	$1,343.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $261.04 / $307.11 / $411.04	Professional	26	$261.04	$307.11	$411.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $500.67 / $589.03 / $917.68	Professional	TC	$500.67	$589.03	$917.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $293.61 / $691.35 / $1,215.28	Professional		$293.61	$691.35	$1,215.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $329.98 / $329.98 / $329.98	Facility	26	$329.98	$329.98	$329.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $995.80 / $1,473.97 / $2,217.12	Professional		$995.80	$1,473.97	$2,217.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $300.36 / $442.95 / $670.97	Professional	26	$300.36	$442.95	$670.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $700.12 / $1,005.91 / $1,546.14	Professional	TC	$700.12	$1,005.91	$1,546.14
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 $1,014.74 / $1,400.32 / $2,211.03	Professional		$1,014.74	$1,400.32	$2,211.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $304.83 / $428.97 / $563.66	Professional	26	$304.83	$428.97	$563.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $687.43 / $945.55 / $1,385.80	Professional	TC	$687.43	$945.55	$1,385.80