Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.54 / $110.06 / $143.44	Facility	26	$96.54	$110.06	$143.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $324.00 / $388.85 / $661.73	Professional		$324.00	$388.85	$661.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.54 / $98.92 / $195.77	Professional	26	$89.54	$98.92	$195.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $231.64 / $294.13 / $381.46	Professional	TC	$231.64	$294.13	$381.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $248.09 / $263.60 / $347.33	Professional		$248.09	$263.60	$347.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.45 / $93.92 / $135.05	Professional	26	$70.45	$93.92	$135.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $333.09 / $333.09 / $340.92	Professional	TC	$333.09	$333.09	$340.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.27 / $696.78 / $944.79	Professional		$303.27	$696.78	$944.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.22 / $169.60 / $234.04	Professional	26	$93.22	$169.60	$234.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $527.17 / $725.00	Professional	TC	$190.00	$527.17	$725.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $261.98 / $403.16	Professional		$92.46	$261.98	$403.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $108.46	Facility	26	$108.46	$108.46	$108.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.57 / $491.80 / $740.96	Professional		$327.57	$491.80	$740.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $119.96 / $209.13	Professional	26	$89.57	$119.96	$209.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.96 / $375.83 / $537.97	Professional	TC	$234.96	$375.83	$537.97
United Facility/Professional Professional Modifier Low / Median / High Price $325.75 / $429.32 / $747.06	Professional		$325.75	$429.32	$747.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.12 / $105.30 / $199.51	Professional	26	$87.12	$105.30	$199.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.45 / $323.69 / $524.79	Professional	TC	$234.45	$323.69	$524.79