Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.07 / $59.37 / $77.37	Facility	26	$52.07	$59.37	$77.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.96 / $148.16 / $245.28	Professional		$130.96	$148.16	$245.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $54.53 / $107.63	Professional	26	$48.28	$54.53	$107.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.06 / $96.22 / $162.30	Professional	TC	$81.06	$96.22	$162.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.36 / $112.27 / $202.72	Professional		$101.36	$112.27	$202.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $43.27 / $71.03	Professional	26	$37.88	$43.27	$71.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $122.08 / $122.08 / $471.25	Professional	TC	$122.08	$122.08	$471.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.67 / $138.52 / $207.78	Professional		$108.67	$138.52	$207.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $50.74 / $76.11	Professional	26	$40.76	$50.74	$76.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.91 / $87.78 / $131.66	Professional	TC	$67.91	$87.78	$131.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $95.22 / $164.71	Professional		$49.72	$95.22	$164.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.64 / $58.64 / $58.64	Facility	26	$58.64	$58.64	$58.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.09 / $181.17 / $297.55	Professional		$133.09	$181.17	$297.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.10 / $62.80 / $109.34	Professional	26	$48.10	$62.80	$109.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.44 / $115.69 / $184.40	Professional	TC	$84.44	$115.69	$184.40
United Facility/Professional Professional Modifier Low / Median / High Price $134.36 / $165.91 / $284.52	Professional		$134.36	$165.91	$284.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.21 / $55.52 / $101.28	Professional	26	$48.21	$55.52	$101.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.63 / $103.57 / $191.12	Professional	TC	$89.63	$103.57	$191.12