Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.84 / $105.40 / $1,352.52	Facility	26	$87.84	$105.40	$1,352.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.45 / $341.58 / $580.00	Professional		$289.45	$341.58	$580.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.31 / $89.48 / $164.00	Professional	26	$80.31	$89.48	$164.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $205.31 / $246.29 / $346.60	Professional	TC	$205.31	$246.29	$346.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.58 / $276.97 / $443.15	Professional		$221.58	$276.97	$443.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $76.92 / $120.18	Professional	26	$64.09	$76.92	$120.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $250.98 / $471.25 / $471.25	Professional	TC	$250.98	$471.25	$471.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.18 / $601.10 / $853.56	Professional		$278.18	$601.10	$853.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.26 / $157.30 / $217.07	Professional	26	$84.26	$157.30	$217.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $443.80 / $630.19	Professional	TC	$190.00	$443.80	$630.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.13 / $233.83 / $360.06	Professional		$84.13	$233.83	$360.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $98.40	Facility	26	$98.40	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.63 / $402.15 / $657.80	Professional		$291.63	$402.15	$657.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.66 / $108.31 / $190.28	Professional	26	$81.66	$108.31	$190.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.10 / $297.52 / $470.38	Professional	TC	$208.10	$297.52	$470.38
United Facility/Professional Professional Modifier Low / Median / High Price $289.82 / $348.22 / $622.53	Professional		$289.82	$348.22	$622.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $97.21 / $181.60	Professional	26	$81.31	$97.21	$181.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.08 / $253.90 / $450.84	Professional	TC	$203.08	$253.90	$450.84