Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $52.48 / $72.44	Facility	26	$41.69	$52.48	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $223.87 / $512.86	Professional		$128.82	$223.87	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $67.61 / $194.98	Professional	26	$38.02	$67.61	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $134.90 / $275.42	Professional	TC	$87.10	$134.90	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $190.55	Professional		$93.33	$112.20	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $33.88 / $64.57	Professional	26	$30.20	$33.88	$64.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $81.28 / $467.74	Professional	TC	$66.07	$81.28	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $389.05	Professional		$169.82	$251.19	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $114.82	Professional	26	$52.48	$81.28	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $169.82 / $269.15	Professional	TC	$117.49	$169.82	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $100.00 / $162.18	Professional		$42.66	$100.00	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $338.84 / $467.74	Professional		$131.83	$338.84	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $64.57 / $120.23	Professional	26	$37.15	$64.57	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $177.83 / $338.84	Professional	TC	$85.11	$177.83	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $204.17 / $346.74	Professional		$125.89	$204.17	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $85.11	Professional	26	$38.90	$53.70	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $138.04 / $263.03	Professional	TC	$87.10	$138.04	$263.03