Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.25 / $186.77 / $322.79	Facility	26	$181.25	$186.77	$322.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.17 / $316.85 / $1,274.00	Professional		$270.17	$316.85	$1,274.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $185.05 / $314.49	Professional	26	$171.18	$185.05	$314.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.54 / $116.85 / $176.41	Professional	TC	$93.54	$116.85	$176.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.10 / $255.49 / $383.24	Professional		$239.10	$255.49	$383.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $158.37 / $220.73 / $237.71	Professional	26	$158.37	$220.73	$237.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.24 / $278.22 / $384.79	Professional		$231.24	$278.22	$384.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $140.87 / $175.84 / $243.21	Professional	26	$140.87	$175.84	$243.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $102.38 / $141.32	Professional	TC	$87.02	$102.38	$141.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $94.26 / $195.26 / $357.69	Professional		$94.26	$195.26	$357.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.08 / $398.05 / $621.35	Professional		$264.08	$398.05	$621.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.23 / $252.52 / $397.64	Professional	26	$173.23	$252.52	$397.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.23 / $148.79 / $226.07	Professional	TC	$90.23	$148.79	$226.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $92.86 / $248.87	Professional		$32.34	$92.86	$248.87
United Facility/Professional Professional Modifier Low / Median / High Price $279.33 / $360.11 / $588.72	Professional		$279.33	$360.11	$588.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $179.07 / $221.11 / $373.52	Professional	26	$179.07	$221.11	$373.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.22 / $138.07 / $209.32	Professional	TC	$101.22	$138.07	$209.32