Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $72.44 / $91.20	Facility	26	$57.54	$72.44	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $436.52	Professional		$131.83	$190.55	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $173.78	Professional	26	$52.48	$81.28	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $112.20 / $257.04	Professional	TC	$79.43	$112.20	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $102.33 / $190.55	Professional		$97.72	$102.33	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $50.12 / $102.33	Professional	26	$41.69	$50.12	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $151.36	Professional	TC	$67.61	$67.61	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $245.47 / $389.05	Professional		$154.88	$245.47	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $77.62 / $120.23	Professional	26	$60.26	$77.62	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $165.96 / $269.15	Professional	TC	$91.20	$165.96	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $93.33 / $169.82	Professional		$57.54	$93.33	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $257.04 / $478.63	Professional		$134.90	$257.04	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $75.86 / $131.83	Professional	26	$50.12	$75.86	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $169.82 / $346.74	Professional	TC	$77.62	$169.82	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $371.54	Professional		$134.90	$213.80	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $107.15	Professional	26	$51.29	$63.10	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $125.89 / $275.42	Professional	TC	$79.43	$125.89	$275.42