Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $141.25 / $190.55	Facility	26	$109.65	$141.25	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $1,096.48	Professional		$331.13	$478.63	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $190.55 / $489.78	Professional	26	$104.71	$190.55	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $323.59 / $676.08	Professional	TC	$218.78	$323.59	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $251.19 / $295.12	Professional		$141.25	$251.19	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $190.55	Professional	26	$81.28	$100.00	$190.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $162.18 / $1,047.13	Professional	TC	$154.88	$162.18	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $588.84 / $912.01	Professional		$389.05	$588.84	$912.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $154.88 / $239.88	Professional	26	$123.03	$154.88	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $436.52 / $676.08	Professional	TC	$269.15	$436.52	$676.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $239.88 / $398.11	Professional		$112.20	$239.88	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $660.69 / $1,513.56	Professional		$316.23	$660.69	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $154.88 / $269.15	Professional	26	$95.50	$154.88	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $457.09 / $1,258.93	Professional	TC	$213.80	$457.09	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $549.54 / $1,258.93	Professional		$338.84	$549.54	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $123.03 / $208.93	Professional	26	$100.00	$123.03	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $371.54 / $1,023.29	Professional	TC	$223.87	$371.54	$1,023.29