Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.29 / $153.69 / $226.70	Facility	26	$123.29	$153.69	$226.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $572.95 / $684.94 / $1,111.10	Professional		$572.95	$684.94	$1,111.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.29 / $128.08 / $222.29	Professional	26	$114.29	$128.08	$222.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $276.43 / $321.61 / $388.94	Professional	52	$276.43	$321.61	$388.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $455.27 / $543.99 / $719.63	Professional	TC	$455.27	$543.99	$719.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $598.42 / $598.42 / $598.42	Professional		$598.42	$598.42	$598.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $105.19 / $147.04 / $177.55	Professional	26	$105.19	$147.04	$177.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $492.45 / $616.00 / $954.80	Professional		$492.45	$616.00	$954.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.39 / $124.76 / $177.15	Professional	26	$105.39	$124.76	$177.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $387.06 / $491.24 / $761.42	Professional	TC	$387.06	$491.24	$761.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.77 / $548.90 / $752.96	Professional		$118.77	$548.90	$752.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $649.11 / $896.19 / $1,712.09	Professional		$649.11	$896.19	$1,712.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.01 / $204.51 / $355.75	Professional	26	$133.01	$204.51	$355.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $517.84 / $694.58 / $1,287.68	Professional	TC	$517.84	$694.58	$1,287.68
United Facility/Professional Professional Modifier Low / Median / High Price $564.53 / $759.20 / $1,416.17	Professional		$564.53	$759.20	$1,416.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.37 / $161.86 / $269.77	Professional	26	$107.37	$161.86	$269.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $449.09 / $601.52 / $1,061.64	Professional	TC	$449.09	$601.52	$1,061.64