Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $123.03 / $165.96	Facility	26	$104.71	$123.03	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $446.68 / $954.99	Professional		$190.55	$446.68	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $181.97 / $457.09	Professional	26	$102.33	$181.97	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $363.08 / $741.31	Professional	TC	$281.84	$363.08	$741.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $346.74 / $512.86	Professional		$338.84	$346.74	$512.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $173.78	Professional	26	$75.86	$95.50	$173.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	TC	$218.78	$218.78	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $549.54 / $870.96	Professional		$446.68	$549.54	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $162.18	Professional	26	$95.50	$114.82	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $446.68 / $691.83	Professional	TC	$338.84	$446.68	$691.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $309.03 / $478.63	Professional		$104.71	$309.03	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $933.25 / $1,778.28	Professional		$426.58	$933.25	$1,778.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $138.04 / $245.47	Professional	26	$89.13	$138.04	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $549.54 / $1,230.27	Professional	TC	$281.84	$549.54	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $602.56 / $1,258.93	Professional		$416.87	$602.56	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $112.20 / $190.55	Professional	26	$91.20	$112.20	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $478.63 / $1,047.13	Professional	TC	$309.03	$478.63	$1,047.13