Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.78 / $148.31 / $228.51	Facility	26	$127.78	$148.31	$228.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.40 / $234.00 / $640.00	Professional		$198.40	$234.00	$640.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.34 / $132.38 / $240.98	Professional	26	$120.34	$132.38	$240.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.94 / $92.39 / $141.93	Professional	TC	$74.94	$92.39	$141.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.21 / $242.85 / $308.24	Professional		$177.21	$242.85	$308.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $111.61 / $149.44 / $167.38	Professional	26	$111.61	$149.44	$167.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.30 / $204.47 / $288.89	Professional		$170.30	$204.47	$288.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.95 / $123.59 / $171.71	Professional	26	$98.95	$123.59	$171.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.73 / $80.87 / $113.71	Professional	TC	$68.73	$80.87	$113.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.30 / $137.49 / $261.52	Professional		$74.30	$137.49	$261.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.65 / $147.65 / $147.65	Facility	26	$147.65	$147.65	$147.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.16 / $302.58 / $464.34	Professional		$195.16	$302.58	$464.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.61 / $177.50 / $280.68	Professional	26	$122.61	$177.50	$280.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.12 / $122.36 / $183.66	Professional	TC	$72.12	$122.36	$183.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.35 / $182.93	Professional		$32.34	$73.35	$182.93
United Facility/Professional Professional Modifier Low / Median / High Price $212.01 / $265.01 / $442.57	Professional		$212.01	$265.01	$442.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.47 / $162.84 / $275.11	Professional	26	$123.47	$162.84	$275.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.40 / $109.60 / $176.69	Professional	TC	$82.40	$109.60	$176.69