Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.22 / $65.45 / $107.10	Facility	26	$56.22	$65.45	$107.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.22 / $210.90 / $332.54	Professional		$158.22	$210.90	$332.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.88 / $56.99 / $126.00	Professional	26	$50.88	$56.99	$126.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.43 / $133.58 / $269.38	Professional	TC	$104.43	$133.58	$269.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.38 / $130.41 / $245.50	Professional		$61.38	$130.41	$245.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $51.13 / $82.98	Professional	26	$40.90	$51.13	$82.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $78.62 / $153.47 / $471.25	Professional	TC	$78.62	$153.47	$471.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.89 / $315.10 / $466.81	Professional		$237.89	$315.10	$466.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $91.73 / $114.02	Professional	26	$64.23	$91.73	$114.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.08 / $221.81 / $343.80	Professional	TC	$171.08	$221.81	$343.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $121.74 / $199.47	Professional		$53.69	$121.74	$199.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.24 / $63.24 / $63.24	Facility	26	$63.24	$63.24	$63.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.26 / $361.01 / $657.70	Professional		$169.26	$361.01	$657.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.47 / $74.97 / $130.59	Professional	26	$52.47	$74.97	$130.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.59 / $256.51 / $527.11	Professional	TC	$111.59	$256.51	$527.11
United Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $272.58 / $493.78	Professional		$183.86	$272.58	$493.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.30 / $65.51 / $124.13	Professional	26	$54.30	$65.51	$124.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.78 / $199.23 / $374.33	Professional	TC	$119.78	$199.23	$374.33