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 / $189.27	Facility	26	$110.41	$125.86	$189.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.89 / $412.67 / $591.58	Professional		$329.89	$412.67	$591.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.69 / $139.88 / $233.46	Professional	26	$105.69	$139.88	$233.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.58 / $270.86 / $368.50	Professional	TC	$218.58	$270.86	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.67 / $255.37 / $471.34	Professional		$235.67	$255.37	$471.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $106.99 / $151.31	Professional	26	$80.69	$106.99	$151.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $261.54 / $261.54 / $261.54	Professional	TC	$261.54	$261.54	$261.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.77 / $606.00 / $872.98	Professional		$392.77	$606.00	$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 $269.70 / $439.60 / $624.23	Professional	TC	$269.70	$439.60	$624.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $230.89 / $382.97	Professional		$105.91	$230.89	$382.97
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 $319.92 / $826.99 / $1,664.24	Professional		$319.92	$826.99	$1,664.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.03 / $153.97 / $265.58	Professional	26	$103.03	$153.97	$265.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.36 / $566.94 / $1,346.73	Professional	TC	$213.36	$566.94	$1,346.73
United Facility/Professional Professional Modifier Low / Median / High Price $331.84 / $581.16 / $1,204.66	Professional		$331.84	$581.16	$1,204.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $128.06 / $234.58	Professional	26	$102.04	$128.06	$234.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $222.42 / $359.74 / $966.90	Professional	TC	$222.42	$359.74	$966.90