Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.96 / $48.93 / $1,250.00	Facility	26	$40.96	$48.93	$1,250.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $134.41 / $219.49	Professional		$100.98	$134.41	$219.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.07 / $42.05 / $90.00	Professional	26	$37.07	$42.05	$90.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.83 / $76.48 / $167.19	Professional	TC	$61.83	$76.48	$167.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.19 / $84.98 / $110.17	Professional		$77.19	$84.98	$110.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $33.45 / $56.06	Professional	26	$29.82	$33.45	$56.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.44 / $471.25 / $471.25	Professional	TC	$47.44	$471.25	$471.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.01 / $227.59 / $338.56	Professional		$124.01	$227.59	$338.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.35 / $62.48 / $79.27	Professional	26	$44.35	$62.48	$79.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.65 / $163.72 / $253.78	Professional	TC	$78.65	$163.72	$253.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $72.54 / $127.87	Professional		$39.24	$72.54	$127.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.92 / $45.92 / $45.92	Facility	26	$45.92	$45.92	$45.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $231.10 / $441.41	Professional		$103.61	$231.10	$441.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $53.37 / $93.27	Professional	26	$38.15	$53.37	$93.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.63 / $158.49 / $352.01	Professional	TC	$64.63	$158.49	$352.01
United Facility/Professional Professional Modifier Low / Median / High Price $104.09 / $171.98 / $298.33	Professional		$104.09	$171.98	$298.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $43.70 / $83.03	Professional	26	$37.11	$43.70	$83.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.29 / $103.07 / $252.12	Professional	TC	$65.29	$103.07	$252.12