Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $186.21 / $257.04	Facility	26	$117.49	$186.21	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $776.25 / $1,380.38	Professional		$575.44	$776.25	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $162.18 / $309.03	Professional	26	$114.82	$162.18	$309.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $204.17 / $257.04 / $1,258.93	Professional	52	$204.17	$257.04	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $616.60 / $1,071.52	Professional	TC	$457.09	$616.60	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $588.84 / $707.95	Professional		$549.54	$588.84	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $147.91 / $186.21	Professional	26	$112.20	$147.91	$186.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $489.78 / $524.81	Professional	TC	$478.63	$489.78	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $575.44 / $933.25	Professional		$489.78	$575.44	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $123.03 / $190.55	Professional	26	$104.71	$123.03	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $457.09 / $741.31	Professional	TC	$389.05	$457.09	$741.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $501.19 / $776.25	Professional		$123.03	$501.19	$776.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $138.04 / $199.53	Facility	26	$29.51	$138.04	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,174.90 / $3,548.13	Professional		$645.65	$1,174.90	$3,548.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $257.04 / $891.25	Professional	26	$131.83	$257.04	$891.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $912.01 / $2,511.89	Professional	TC	$501.19	$912.01	$2,511.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $478.63	Professional		$32.36	$33.11	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $831.76 / $1,288.25	Professional		$588.84	$831.76	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $177.83 / $288.40	Professional	26	$123.03	$177.83	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $645.65 / $1,000.00	Professional	TC	$457.09	$645.65	$1,000.00