Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $72.44 / $95.50	Facility	26	$60.26	$72.44	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $501.19	Professional		$194.98	$257.04	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $194.98	Professional	26	$56.23	$81.28	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $177.83 / $354.81	Professional	TC	$134.90	$177.83	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $147.91 / $173.78	Professional		$64.57	$147.91	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $51.29 / $100.00	Professional	26	$43.65	$51.29	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $114.82 / $251.19	Professional	TC	$102.33	$114.82	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $354.81 / $549.54	Professional		$257.04	$354.81	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $138.04	Professional	26	$69.18	$89.13	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $263.03 / $407.38	Professional	TC	$186.21	$263.03	$407.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $147.91 / $245.47	Professional		$60.26	$147.91	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $380.19 / $707.95	Professional		$194.98	$380.19	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $158.49	Professional	26	$52.48	$83.18	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $281.84 / $575.44	Professional	TC	$138.04	$281.84	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $331.13 / $549.54	Professional		$218.78	$331.13	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $123.03	Professional	26	$57.54	$70.79	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $245.47 / $457.09	Professional	TC	$151.36	$245.47	$457.09