Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $61.66 / $77.62	Facility	26	$47.86	$61.66	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $512.86	Professional		$128.82	$208.93	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $61.66 / $199.53	Professional	26	$42.66	$61.66	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $120.23 / $288.40	Professional	TC	$79.43	$120.23	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $123.03	Professional		$87.10	$107.15	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $39.81 / $74.13	Professional	26	$34.67	$39.81	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	TC	$467.74	$467.74	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $389.05	Professional		$173.78	$245.47	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $117.49	Professional	26	$53.70	$75.86	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $165.96 / $269.15	Professional	TC	$120.23	$165.96	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $95.50 / $162.18	Professional		$47.86	$95.50	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $398.11 / $549.54	Professional		$151.36	$398.11	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $67.61 / $125.89	Professional	26	$41.69	$67.61	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $177.83 / $389.05	Professional	TC	$83.18	$177.83	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $380.19	Professional		$144.54	$218.78	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $56.23 / $93.33	Professional	26	$44.67	$56.23	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $154.88 / $288.40	Professional	TC	$95.50	$154.88	$288.40