Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $77.62 / $97.72	Facility	26	$61.66	$77.62	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $616.60	Professional		$223.87	$316.23	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $102.33 / $218.78	Professional	26	$57.54	$102.33	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $416.87	Professional	TC	$158.49	$218.78	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $309.03	Professional		$173.78	$181.97	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $58.88 / $112.20	Professional	26	$44.67	$58.88	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	TC	$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $489.78	Professional		$239.88	$316.23	$489.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $131.83	Professional	26	$67.61	$95.50	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $223.87 / $354.81	Professional	TC	$169.82	$223.87	$354.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $194.98 / $288.40	Professional		$63.10	$194.98	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $398.11 / $660.69	Professional		$89.13	$398.11	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $81.28 / $144.54	Professional	26	$53.70	$81.28	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $269.15 / $512.86	Professional	TC	$158.49	$269.15	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $489.78	Professional		$218.78	$302.00	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $66.07 / $114.82	Professional	26	$54.95	$66.07	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $234.42 / $389.05	Professional	TC	$158.49	$234.42	$389.05