Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.27 / $99.27 / $129.94	Facility	26	$99.27	$99.27	$129.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.07 / $279.04 / $487.30	Professional		$242.07	$279.04	$487.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.50 / $101.20 / $155.77	Professional	26	$91.50	$101.20	$155.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.22 / $188.48 / $330.97	Professional	TC	$148.22	$188.48	$330.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $122.97 / $122.97 / $122.97	Professional	26	$122.97	$122.97	$122.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.80 / $299.06 / $394.04	Professional		$190.80	$299.06	$394.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.86 / $90.06 / $150.81	Professional	26	$70.86	$90.06	$150.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.66 / $216.91 / $268.48	Professional	TC	$67.66	$216.91	$268.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.21 / $142.44 / $357.13	Professional		$102.21	$142.44	$357.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.16 / $335.79 / $682.94	Professional		$197.16	$335.79	$682.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.49 / $136.97 / $210.31	Professional	26	$95.49	$136.97	$210.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.46 / $199.30 / $428.20	Professional	TC	$98.46	$199.30	$428.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.61 / $127.73	Professional		$32.34	$46.61	$127.73
United Facility/Professional Professional Modifier Low / Median / High Price $199.47 / $314.95 / $496.59	Professional		$199.47	$314.95	$496.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.17 / $124.58 / $208.22	Professional	26	$88.17	$124.58	$208.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.21 / $176.54 / $284.27	Professional	TC	$99.21	$176.54	$284.27