Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.09 / $86.09 / $132.19	Facility	26	$86.09	$86.09	$132.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.69 / $344.36 / $488.59	Professional		$277.69	$344.36	$488.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $105.98 / $155.65	Professional	26	$85.16	$105.98	$155.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $133.54 / $149.52 / $237.50	Professional	52	$133.54	$149.52	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.40 / $238.28 / $340.00	Professional	TC	$191.40	$238.28	$340.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.57 / $78.22 / $138.94	Professional	26	$62.57	$78.22	$138.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $132.58 / $132.58 / $132.58	Professional	TC	$132.58	$132.58	$132.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.51 / $448.61 / $695.34	Professional		$331.51	$448.61	$695.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.87 / $115.80 / $169.81	Professional	26	$91.87	$115.80	$169.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.33 / $332.81 / $515.85	Professional	TC	$235.33	$332.81	$515.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.11 / $213.08 / $335.72	Professional		$83.11	$213.08	$335.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.86 / $605.80 / $1,113.00	Professional		$270.86	$605.80	$1,113.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.04 / $112.23 / $186.60	Professional	26	$80.04	$112.23	$186.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $187.11 / $479.11 / $903.56	Professional	TC	$187.11	$479.11	$903.56
United Facility/Professional Professional Modifier Low / Median / High Price $282.26 / $481.20 / $858.12	Professional		$282.26	$481.20	$858.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $96.01 / $182.62	Professional	26	$77.62	$96.01	$182.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.96 / $349.93 / $699.36	Professional	TC	$188.96	$349.93	$699.36