Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.01 / $95.78 / $124.83	Facility	26	$84.01	$95.78	$124.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.51 / $213.75 / $323.66	Professional		$175.51	$213.75	$323.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.81 / $84.27 / $175.70	Professional	26	$76.81	$84.27	$175.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.96 / $119.50 / $156.10	Professional	TC	$94.96	$119.50	$156.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.75 / $144.24 / $254.54	Professional		$135.75	$144.24	$254.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.91 / $64.95 / $114.50	Professional	26	$60.91	$64.95	$114.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $119.04 / $471.25 / $471.25	Professional	TC	$119.04	$471.25	$471.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.57 / $483.02 / $685.88	Professional		$200.57	$483.02	$685.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.36 / $147.30 / $203.27	Professional	26	$80.36	$147.30	$203.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.21 / $335.72 / $476.72	Professional	TC	$120.21	$335.72	$476.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.15 / $112.03 / $220.60	Professional		$80.15	$112.03	$220.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.15 / $94.15 / $94.15	Facility	26	$94.15	$94.15	$94.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.17 / $254.64 / $400.71	Professional		$177.17	$254.64	$400.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.52 / $103.43 / $181.27	Professional	26	$77.52	$103.43	$181.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.13 / $153.13 / $221.73	Professional	TC	$98.13	$153.13	$221.73
United Facility/Professional Professional Modifier Low / Median / High Price $177.85 / $223.50 / $386.62	Professional		$177.85	$223.50	$386.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.77 / $93.71 / $173.07	Professional	26	$75.77	$93.71	$173.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.98 / $131.84 / $225.85	Professional	TC	$100.98	$131.84	$225.85