Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.97 / $57.97 / $89.10	Facility	26	$57.97	$57.97	$89.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.71 / $275.38 / $475.00	Professional		$220.71	$275.38	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.97 / $73.37 / $140.00	Professional	26	$57.97	$73.37	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.74 / $202.01 / $335.00	Professional	TC	$162.74	$202.01	$335.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.01 / $163.01 / $163.01	Professional		$163.01	$163.01	$163.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $48.02 / $65.95	Professional	26	$41.96	$48.02	$65.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.14 / $398.49 / $598.71	Professional		$344.14	$398.49	$598.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.00 / $89.72 / $116.25	Professional	26	$62.00	$89.72	$116.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $282.76 / $308.77 / $478.59	Professional	TC	$282.76	$308.77	$478.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $168.42 / $267.49	Professional		$56.02	$168.42	$267.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.43 / $545.84 / $919.41	Professional		$217.43	$545.84	$919.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.80 / $74.36 / $125.61	Professional	26	$53.80	$74.36	$125.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.55 / $441.44 / $819.23	Professional	TC	$158.55	$441.44	$819.23
United Facility/Professional Professional Modifier Low / Median / High Price $230.08 / $400.16 / $709.14	Professional		$230.08	$400.16	$709.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.42 / $64.38 / $112.10	Professional	26	$52.42	$64.38	$112.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.90 / $320.26 / $601.24	Professional	TC	$166.90	$320.26	$601.24