Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.02 / $109.02 / $167.82	Facility	26	$109.02	$109.02	$167.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.25 / $494.75 / $661.50	Professional		$426.25	$494.75	$661.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.60 / $132.85 / $201.00	Professional	26	$107.60	$132.85	$201.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $321.86 / $366.66 / $502.93	Professional	TC	$321.86	$366.66	$502.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $352.94 / $372.04 / $372.04	Professional		$352.94	$372.04	$372.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $101.90 / $119.16 / $177.31	Professional	26	$101.90	$119.16	$177.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $443.52 / $554.41 / $859.33	Professional		$443.52	$554.41	$859.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.20 / $108.10 / $167.55	Professional	26	$97.20	$108.10	$167.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $357.04 / $446.31 / $669.46	Professional	TC	$357.04	$446.31	$669.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.51 / $395.50 / $578.99	Professional		$105.51	$395.50	$578.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Facility	26	$122.33	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $474.45 / $1,018.57 / $1,529.54	Professional		$474.45	$1,018.57	$1,529.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.41 / $139.43 / $236.78	Professional	26	$101.41	$139.43	$236.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.16 / $802.57 / $1,271.86	Professional	TC	$363.16	$802.57	$1,271.86
United Facility/Professional Professional Modifier Low / Median / High Price $491.60 / $735.11 / $1,261.83	Professional		$491.60	$735.11	$1,261.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.30 / $117.26 / $213.90	Professional	26	$99.30	$117.26	$213.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $396.02 / $629.45 / $988.02	Professional	TC	$396.02	$629.45	$988.02