Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.19 / $124.19 / $191.68	Facility	26	$124.19	$124.19	$191.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.10 / $450.12 / $525.00	Professional		$375.10	$450.12	$525.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.94 / $140.00 / $253.40	Professional	26	$122.94	$140.00	$253.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.04 / $304.99 / $358.43	Professional	TC	$249.04	$304.99	$358.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $286.44 / $497.40 / $497.40	Professional		$286.44	$497.40	$497.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.74 / $138.91 / $170.13	Professional	26	$90.74	$138.91	$170.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $424.95 / $764.98 / $1,086.27	Professional		$424.95	$764.98	$1,086.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $137.41 / $180.57 / $256.39	Professional	26	$137.41	$180.57	$256.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $294.44 / $584.41 / $829.87	Professional	TC	$294.44	$584.41	$829.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.09 / $259.95 / $431.08	Professional		$119.09	$259.95	$431.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.76 / $707.91 / $1,078.45	Professional		$364.76	$707.91	$1,078.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.95 / $154.15 / $268.18	Professional	26	$115.95	$154.15	$268.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $240.53 / $518.17 / $819.69	Professional	TC	$240.53	$518.17	$819.69
United Facility/Professional Professional Modifier Low / Median / High Price $377.33 / $554.54 / $959.31	Professional		$377.33	$554.54	$959.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.80 / $137.96 / $287.95	Professional	26	$110.80	$137.96	$287.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $256.50 / $401.81 / $692.61	Professional	TC	$256.50	$401.81	$692.61