Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.51 / $102.17 / $130.03	Facility	26	$87.51	$102.17	$130.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.76 / $319.92 / $477.07	Professional		$257.76	$319.92	$477.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.81 / $88.09 / $190.04	Professional	26	$79.81	$88.09	$190.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $212.93 / $364.62	Professional	TC	$170.48	$212.93	$364.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $207.15 / $207.15 / $414.00	Professional		$207.15	$207.15	$414.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.86 / $69.08 / $119.73	Professional	26	$63.86	$69.08	$119.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $163.90 / $163.90 / $221.27	Professional	TC	$163.90	$163.90	$221.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $287.45 / $359.32 / $556.94	Professional		$287.45	$359.32	$556.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.13 / $94.32 / $141.47	Professional	26	$77.13	$94.32	$141.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $212.00 / $265.00 / $397.50	Professional	TC	$212.00	$265.00	$397.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.81 / $213.01 / $336.62	Professional		$83.81	$213.01	$336.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.18 / $501.62 / $903.28	Professional		$277.18	$501.62	$903.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.37 / $113.51 / $199.23	Professional	26	$81.37	$113.51	$199.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.50 / $389.72 / $670.97	Professional	TC	$192.50	$389.72	$670.97
United Facility/Professional Professional Modifier Low / Median / High Price $273.10 / $414.68 / $735.96	Professional		$273.10	$414.68	$735.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.78 / $97.97 / $172.69	Professional	26	$80.78	$97.97	$172.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.81 / $325.68 / $591.33	Professional	TC	$186.81	$325.68	$591.33