Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $120.00 / $156.38	Facility	26	$105.26	$120.00	$156.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $360.31 / $418.32 / $596.01	Professional		$360.31	$418.32	$596.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.92 / $110.09 / $228.57	Professional	26	$93.92	$110.09	$228.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.44 / $308.23 / $447.91	Professional	TC	$259.44	$308.23	$447.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $278.56 / $287.17 / $348.21	Professional		$278.56	$287.17	$348.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.93 / $82.77 / $144.26	Professional	26	$76.93	$82.77	$144.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $340.25 / $340.25 / $340.25	Professional	TC	$340.25	$340.25	$340.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $491.95 / $601.48 / $854.10	Professional		$491.95	$601.48	$854.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.97 / $101.65 / $152.47	Professional	26	$100.97	$101.65	$152.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $374.15 / $484.59 / $688.11	Professional	TC	$374.15	$484.59	$688.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $295.64 / $452.67	Professional		$100.98	$295.64	$452.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.52 / $118.52 / $118.52	Facility	26	$118.52	$118.52	$118.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.78 / $626.77 / $887.19	Professional		$362.78	$626.77	$887.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.19 / $129.13 / $229.19	Professional	26	$98.19	$129.13	$229.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.58 / $493.07 / $713.93	Professional	TC	$264.58	$493.07	$713.93
United Facility/Professional Professional Modifier Low / Median / High Price $361.92 / $524.15 / $858.69	Professional		$361.92	$524.15	$858.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.34 / $118.76 / $228.02	Professional	26	$97.34	$118.76	$228.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $256.93 / $402.51 / $661.40	Professional	TC	$256.93	$402.51	$661.40