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 $297.56 / $415.73 / $608.16	Professional		$297.56	$415.73	$608.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.18 / $131.22 / $262.50	Professional	26	$99.18	$131.22	$262.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.16 / $289.57 / $392.11	Professional	TC	$242.16	$289.57	$392.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $242.08 / $247.20 / $267.82	Professional		$242.08	$247.20	$267.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.75 / $97.08 / $142.04	Professional	26	$75.75	$97.08	$142.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $240.02 / $240.02 / $240.02	Professional	TC	$240.02	$240.02	$240.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.77 / $547.27 / $777.12	Professional		$386.77	$547.27	$777.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.40 / $102.77 / $159.29	Professional	26	$91.40	$102.77	$159.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $340.00 / $444.50 / $631.19	Professional	TC	$340.00	$444.50	$631.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.42 / $254.75 / $401.69	Professional		$99.42	$254.75	$401.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.71 / $774.32 / $1,515.45	Professional		$339.71	$774.32	$1,515.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.36 / $128.63 / $224.89	Professional	26	$96.36	$128.63	$224.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.27 / $649.78 / $1,323.27	Professional	TC	$236.27	$649.78	$1,323.27
United Facility/Professional Professional Modifier Low / Median / High Price $365.65 / $590.29 / $1,225.01	Professional		$365.65	$590.29	$1,225.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.95 / $109.80 / $224.57	Professional	26	$92.95	$109.80	$224.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.74 / $453.29 / $967.38	Professional	TC	$260.74	$453.29	$967.38