Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $87.10 / $120.23	Facility	26	$53.70	$87.10	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $812.83	Professional		$371.54	$446.68	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $131.83	Professional	26	$53.70	$64.57	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $380.19 / $660.69	Professional	TC	$323.59	$380.19	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $67.61 / $125.89	Professional	26	$18.20	$67.61	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $398.11	Professional	TC	$371.54	$371.54	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $660.69	Professional		$316.23	$371.54	$660.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $57.54 / $112.20	Professional	26	$48.98	$57.54	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $562.34	Professional	TC	$269.15	$316.23	$562.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $83.18	Professional		$47.86	$66.07	$83.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	26	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $794.33 / $2,041.74	Professional		$426.58	$794.33	$2,041.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $125.89 / $446.68	Professional	26	$61.66	$125.89	$446.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $676.08 / $1,778.28	Professional	TC	$363.08	$676.08	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $870.96	Professional		$371.54	$524.81	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $138.04	Professional	26	$57.54	$89.13	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $426.58 / $741.31	Professional	TC	$316.23	$426.58	$741.31