Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.75 / $123.66 / $163.27	Facility	26	$105.75	$123.66	$163.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.73 / $433.92 / $645.00	Professional		$330.73	$433.92	$645.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.26 / $140.00 / $215.62	Professional	26	$102.26	$140.00	$215.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.98 / $300.08 / $394.51	Professional	TC	$220.98	$300.08	$394.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $241.98 / $247.06 / $374.26	Professional		$241.98	$247.06	$374.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.28 / $100.83 / $144.91	Professional	26	$77.28	$100.83	$144.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $165.04 / $270.58 / $270.58	Professional	TC	$165.04	$270.58	$270.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $442.07 / $552.59 / $828.88	Professional		$442.07	$552.59	$828.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.00 / $109.00 / $168.95	Professional	26	$98.00	$109.00	$168.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $340.00 / $443.59 / $629.89	Professional	TC	$340.00	$443.59	$629.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.44 / $252.26 / $401.47	Professional		$101.44	$252.26	$401.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.37 / $800.00 / $1,410.89	Professional		$342.37	$800.00	$1,410.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.64 / $137.33 / $236.78	Professional	26	$98.64	$137.33	$236.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.98 / $638.24 / $1,243.47	Professional	TC	$233.98	$638.24	$1,243.47
United Facility/Professional Professional Modifier Low / Median / High Price $366.14 / $627.23 / $1,192.82	Professional		$366.14	$627.23	$1,192.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.10 / $115.46 / $220.23	Professional	26	$95.10	$115.46	$220.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $258.77 / $419.21 / $1,010.55	Professional	TC	$258.77	$419.21	$1,010.55