Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.40 / $118.70 / $182.90	Facility	26	$102.40	$118.70	$182.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.50 / $196.18 / $735.00	Professional		$165.50	$196.18	$735.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $105.91 / $212.74	Professional	26	$96.29	$105.91	$212.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.54 / $79.70 / $128.46	Professional	TC	$65.54	$79.70	$128.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.59 / $201.86 / $232.92	Professional		$147.59	$201.86	$232.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $119.62 / $124.41 / $133.97	Professional	26	$119.62	$124.41	$133.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.87 / $168.61 / $237.28	Professional		$140.87	$168.61	$237.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.42 / $98.92 / $137.44	Professional	26	$79.42	$98.92	$137.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.23 / $69.69 / $98.46	Professional	TC	$59.23	$69.69	$98.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.54 / $110.64 / $217.39	Professional		$65.54	$110.64	$217.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.19 / $118.19 / $118.19	Facility	26	$118.19	$118.19	$118.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.56 / $250.09 / $382.91	Professional		$161.56	$250.09	$382.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.15 / $142.04 / $224.64	Professional	26	$98.15	$142.04	$224.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.07 / $105.49 / $158.27	Professional	TC	$63.07	$105.49	$158.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $63.21 / $151.13	Professional		$32.34	$63.21	$151.13
United Facility/Professional Professional Modifier Low / Median / High Price $174.99 / $223.41 / $370.29	Professional		$174.99	$223.41	$370.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.04 / $131.54 / $216.56	Professional	26	$100.04	$131.54	$216.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $94.40 / $154.52	Professional	TC	$72.95	$94.40	$154.52