Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.75 / $120.55 / $163.27	Facility	26	$105.75	$120.55	$163.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.77 / $435.52 / $652.89	Professional		$323.77	$435.52	$652.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.17 / $133.84 / $223.58	Professional	26	$101.17	$133.84	$223.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.85 / $301.69 / $408.00	Professional	TC	$240.85	$301.69	$408.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.88 / $255.52 / $475.28	Professional		$247.88	$255.52	$475.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.28 / $96.61 / $144.91	Professional	26	$77.28	$96.61	$144.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $272.10 / $984.75 / $984.75	Professional	TC	$272.10	$984.75	$984.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $442.07 / $552.59 / $828.88	Professional		$442.07	$552.59	$828.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.00 / $109.00 / $168.95	Professional	26	$98.00	$109.00	$168.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $340.00 / $443.59 / $629.89	Professional	TC	$340.00	$443.59	$629.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.44 / $253.68 / $403.03	Professional		$101.44	$253.68	$403.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.98 / $800.00 / $1,410.89	Professional		$342.98	$800.00	$1,410.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.64 / $137.33 / $236.78	Professional	26	$98.64	$137.33	$236.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.29 / $639.34 / $1,243.47	Professional	TC	$235.29	$639.34	$1,243.47
United Facility/Professional Professional Modifier Low / Median / High Price $366.79 / $595.46 / $1,245.71	Professional		$366.79	$595.46	$1,245.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.10 / $118.18 / $208.40	Professional	26	$95.10	$118.18	$208.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.64 / $451.47 / $925.00	Professional	TC	$252.64	$451.47	$925.00