Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.43 / $89.42 / $108.71	Facility	26	$78.43	$89.42	$108.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.77 / $394.62 / $623.00	Professional		$297.77	$394.62	$623.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $99.24 / $165.86	Professional	26	$78.44	$99.24	$165.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.83 / $298.69 / $368.50	Professional	TC	$241.83	$298.69	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $227.60 / $233.75 / $246.13	Professional		$227.60	$233.75	$246.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $71.39 / $109.11	Professional	26	$57.11	$71.39	$109.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $271.72 / $271.72 / $271.72	Professional	TC	$271.72	$271.72	$271.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.88 / $409.83 / $635.23	Professional		$341.88	$409.83	$635.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.80 / $74.30 / $115.16	Professional	26	$66.80	$74.30	$115.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.42 / $335.53 / $520.07	Professional	TC	$268.42	$335.53	$520.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $245.08 / $369.86	Professional		$74.95	$245.08	$369.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.47 / $615.17 / $1,013.07	Professional		$314.47	$615.17	$1,013.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.93 / $99.84 / $169.80	Professional	26	$72.93	$99.84	$169.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.96 / $506.13 / $791.02	Professional	TC	$234.96	$506.13	$791.02
United Facility/Professional Professional Modifier Low / Median / High Price $334.22 / $465.00 / $797.76	Professional		$334.22	$465.00	$797.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.12 / $84.87 / $154.79	Professional	26	$71.12	$84.87	$154.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.00 / $382.55 / $634.87	Professional	TC	$249.00	$382.55	$634.87