Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $114.82 / $147.91	Facility	26	$95.50	$114.82	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $851.14	Professional		$309.03	$446.68	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $131.83 / $331.13	Professional	26	$89.13	$131.83	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $323.59 / $602.56	Professional	TC	$223.87	$323.59	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $281.84 / $446.68	Professional		$251.19	$281.84	$446.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $87.10 / $147.91	Professional	26	$70.79	$87.10	$147.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $204.17 / $436.52	Professional	TC	$162.18	$204.17	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $691.83 / $1,047.13	Professional		$302.00	$691.83	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $169.82 / $257.04	Professional	26	$93.33	$169.82	$257.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $524.81 / $812.83	Professional	TC	$190.55	$524.81	$812.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $275.42 / $426.58	Professional		$97.72	$275.42	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $794.33	Professional		$323.59	$478.63	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $208.93	Professional	26	$81.28	$125.89	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $363.08 / $602.56	Professional	TC	$234.42	$363.08	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $707.95	Professional		$323.59	$426.58	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $107.15 / $186.21	Professional	26	$87.10	$107.15	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $316.23 / $512.86	Professional	TC	$234.42	$316.23	$512.86