Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.32 / $120.82 / $177.11	Facility	26	$103.32	$120.82	$177.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.73 / $435.73 / $623.01	Professional		$348.73	$435.73	$623.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.00 / $130.83 / $199.08	Professional	26	$102.00	$130.83	$199.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.80 / $304.89 / $386.94	Professional	TC	$243.80	$304.89	$386.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $248.63 / $264.17 / $348.08	Professional		$248.63	$264.17	$348.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.51 / $105.72 / $145.19	Professional	26	$75.51	$105.72	$145.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $1,048.45 / $1,048.45 / $1,048.45	Professional	TC	$1,048.45	$1,048.45	$1,048.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $437.68 / $547.10 / $820.65	Professional		$437.68	$547.10	$820.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.20 / $102.60 / $159.03	Professional	26	$90.20	$102.60	$159.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $337.20 / $444.50 / $631.19	Professional	TC	$337.20	$444.50	$631.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.11 / $257.22 / $404.01	Professional		$99.11	$257.22	$404.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $341.65 / $800.00 / $1,390.44	Professional		$341.65	$800.00	$1,390.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.34 / $128.63 / $224.17	Professional	26	$96.34	$128.63	$224.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $238.56 / $633.83 / $1,179.42	Professional	TC	$238.56	$633.83	$1,179.42
United Facility/Professional Professional Modifier Low / Median / High Price $355.99 / $593.30 / $1,232.58	Professional		$355.99	$593.30	$1,232.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.13 / $114.85 / $207.08	Professional	26	$95.13	$114.85	$207.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.27 / $457.90 / $961.64	Professional	TC	$253.27	$457.90	$961.64