Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $162.18 / $199.53	Facility	26	$123.03	$162.18	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $501.19 / $1,174.90	Professional		$371.54	$501.19	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $213.80 / $467.74	Professional	26	$120.23	$213.80	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $602.56	Professional	TC	$251.19	$338.84	$602.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $151.36 / $223.87	Professional	26	$93.33	$151.36	$223.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $616.60 / $616.60	Professional	TC	$616.60	$616.60	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $758.58 / $1,174.90	Professional		$426.58	$758.58	$1,174.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $181.97 / $281.84	Professional	26	$138.04	$181.97	$281.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $588.84 / $912.01	Professional	TC	$288.40	$588.84	$912.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $275.42 / $457.09	Professional		$125.89	$275.42	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $630.96 / $1,122.02	Professional		$363.08	$630.96	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $162.18 / $281.84	Professional	26	$107.15	$162.18	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $457.09 / $812.83	Professional	TC	$239.88	$457.09	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $537.03 / $954.99	Professional		$380.19	$537.03	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $138.04 / $234.42	Professional	26	$109.65	$138.04	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $398.11 / $741.31	Professional	TC	$263.03	$398.11	$741.31