Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.41 / $125.86 / $173.05	Facility	26	$110.41	$125.86	$173.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.97 / $411.87 / $598.50	Professional		$305.97	$411.87	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.27 / $140.00 / $246.55	Professional	26	$109.27	$140.00	$246.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.28 / $270.02 / $368.50	Professional	TC	$200.28	$270.02	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.20 / $254.85 / $470.40	Professional		$235.20	$254.85	$470.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $106.99 / $155.19	Professional	26	$80.69	$106.99	$155.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $260.73 / $516.75 / $516.75	Professional	TC	$260.73	$516.75	$516.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.41 / $606.17 / $872.98	Professional		$392.41	$606.17	$872.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.07 / $166.40 / $237.71	Professional	26	$123.07	$166.40	$237.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.36 / $439.78 / $624.48	Professional	TC	$269.36	$439.78	$624.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $230.18 / $382.20	Professional		$105.91	$230.18	$382.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.27 / $763.66 / $1,622.07	Professional		$323.27	$763.66	$1,622.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.03 / $154.59 / $279.66	Professional	26	$103.03	$154.59	$279.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.05 / $607.00 / $1,346.73	Professional	TC	$213.05	$607.00	$1,346.73
United Facility/Professional Professional Modifier Low / Median / High Price $330.07 / $560.29 / $1,270.13	Professional		$330.07	$560.29	$1,270.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.36 / $126.19 / $239.20	Professional	26	$104.36	$126.19	$239.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $230.62 / $384.36 / $979.14	Professional	TC	$230.62	$384.36	$979.14