Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.64 / $103.64 / $160.03	Facility	26	$103.64	$103.64	$160.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $683.00	Professional		$370.50	$475.00	$683.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.00 / $128.65 / $187.00	Professional	26	$102.00	$128.65	$187.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $291.39 / $335.00 / $455.24	Professional	TC	$291.39	$335.00	$455.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.08 / $299.08 / $324.32	Professional		$299.08	$299.08	$324.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.41 / $94.69 / $135.16	Professional	26	$75.41	$94.69	$135.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $430.86 / $540.70 / $811.05	Professional		$430.86	$540.70	$811.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.80 / $96.20 / $149.11	Professional	26	$91.80	$96.20	$149.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $355.60 / $444.50 / $666.75	Professional	TC	$355.60	$444.50	$666.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.61 / $320.36 / $504.72	Professional		$100.61	$320.36	$504.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.09 / $877.14 / $1,515.98	Professional		$412.09	$877.14	$1,515.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.66 / $129.59 / $226.22	Professional	26	$96.66	$129.59	$226.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $311.79 / $677.39 / $1,287.07	Professional	TC	$311.79	$677.39	$1,287.07
United Facility/Professional Professional Modifier Low / Median / High Price $430.82 / $660.94 / $1,248.36	Professional		$430.82	$660.94	$1,248.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.45 / $116.59 / $225.28	Professional	26	$95.45	$116.59	$225.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $333.54 / $496.04 / $942.97	Professional	TC	$333.54	$496.04	$942.97