Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $153.15 / $177.88 / $272.98	Facility	26	$153.15	$177.88	$272.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.86 / $269.79 / $896.00	Professional		$233.86	$269.79	$896.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $156.12 / $255.80	Professional	26	$144.25	$156.12	$255.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.69 / $104.53 / $159.72	Professional	TC	$84.69	$104.53	$159.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $206.43 / $221.97 / $327.08	Professional		$206.43	$221.97	$327.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $133.47 / $197.54 / $200.41	Professional	26	$133.47	$197.54	$200.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.73 / $239.73 / $331.54	Professional		$199.73	$239.73	$331.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $119.00 / $148.22 / $205.02	Professional	26	$119.00	$148.22	$205.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.77 / $91.50 / $126.55	Professional	TC	$77.77	$91.50	$126.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $164.62 / $305.27	Professional		$82.40	$164.62	$305.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.48 / $344.08 / $537.95	Professional		$228.48	$344.08	$537.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $146.47 / $212.85 / $335.64	Professional	26	$146.47	$212.85	$335.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.47 / $133.94 / $202.30	Professional	TC	$81.47	$133.94	$202.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $82.98 / $214.73	Professional		$32.34	$82.98	$214.73
United Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $310.50 / $502.70	Professional		$238.46	$310.50	$502.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $148.11 / $193.71 / $319.30	Professional	26	$148.11	$193.71	$319.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.12 / $114.81 / $188.19	Professional	TC	$91.12	$114.81	$188.19