Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.69 / $66.90 / $90.20	Facility	26	$58.69	$66.90	$90.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.71 / $207.18 / $331.85	Professional		$169.71	$207.18	$331.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.97 / $58.69 / $98.00	Professional	26	$54.97	$58.69	$98.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.18 / $137.68 / $269.75	Professional	TC	$110.18	$137.68	$269.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $128.12 / $128.12	Professional		$128.12	$128.12	$128.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $48.59 / $99.54	Professional	26	$42.70	$48.59	$99.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.09 / $300.70 / $465.62	Professional		$237.09	$300.70	$465.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $78.90 / $113.56	Professional	26	$62.37	$78.90	$113.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.42 / $221.81 / $343.80	Professional	TC	$171.42	$221.81	$343.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.04 / $122.01 / $202.38	Professional		$56.04	$122.01	$202.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.04 / $364.20 / $655.04	Professional		$171.04	$364.20	$655.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.78 / $76.09 / $133.60	Professional	26	$54.78	$76.09	$133.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.59 / $268.68 / $527.11	Professional	TC	$111.59	$268.68	$527.11
United Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $272.22 / $474.14	Professional		$182.24	$272.22	$474.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.07 / $65.69 / $121.32	Professional	26	$53.07	$65.69	$121.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.77 / $204.62 / $349.29	Professional	TC	$122.77	$204.62	$349.29