Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.40 / $85.54 / $149.72	Facility	26	$83.40	$85.54	$149.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.98 / $405.58 / $755.46	Professional		$365.98	$405.58	$755.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.25 / $90.32 / $369.00	Professional	26	$80.25	$90.32	$369.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $284.67 / $320.56 / $617.02	Professional	TC	$284.67	$320.56	$617.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.04 / $537.04 / $537.04	Professional		$537.04	$537.04	$537.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.65 / $98.62 / $108.86	Professional	26	$72.65	$98.62	$108.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.69 / $381.93 / $531.37	Professional		$234.69	$381.93	$531.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.59 / $75.31 / $156.47	Professional	26	$61.59	$75.31	$156.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.31 / $271.37 / $423.65	Professional	TC	$149.31	$271.37	$423.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.76 / $112.75 / $565.57	Professional		$77.76	$112.75	$565.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.89 / $434.51 / $758.65	Professional		$274.89	$434.51	$758.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.31 / $119.05 / $180.57	Professional	26	$80.31	$119.05	$180.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.65 / $321.32 / $592.59	Professional	TC	$190.65	$321.32	$592.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $69.81 / $316.97	Professional		$32.34	$69.81	$316.97
United Facility/Professional Professional Modifier Low / Median / High Price $260.16 / $387.03 / $762.45	Professional		$260.16	$387.03	$762.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.73 / $108.12 / $175.22	Professional	26	$75.73	$108.12	$175.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.85 / $299.42 / $598.84	Professional	TC	$180.85	$299.42	$598.84