Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.68 / $127.68 / $175.47	Facility	26	$113.68	$127.68	$175.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $327.06 / $492.70	Professional		$275.00	$327.06	$492.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.37 / $115.62 / $229.14	Professional	26	$104.37	$115.62	$229.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.55 / $213.12 / $364.43	Professional	TC	$164.55	$213.12	$364.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $310.35 / $428.11 / $428.11	Professional		$310.35	$428.11	$428.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.06 / $110.08 / $169.35	Professional	26	$83.06	$110.08	$169.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $163.75 / $477.75 / $477.75	Professional	TC	$163.75	$477.75	$477.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $311.79 / $388.10 / $599.00	Professional		$311.79	$388.10	$599.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.02 / $123.10 / $190.80	Professional	26	$109.02	$123.10	$190.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $212.00 / $265.00 / $410.75	Professional	TC	$212.00	$265.00	$410.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.02 / $313.86 / $489.76	Professional		$109.02	$313.86	$489.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $395.25 / $693.73 / $1,001.87	Professional		$395.25	$693.73	$1,001.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.84 / $140.05 / $250.36	Professional	26	$105.84	$140.05	$250.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $283.85 / $506.06 / $765.29	Professional	TC	$283.85	$506.06	$765.29
United Facility/Professional Professional Modifier Low / Median / High Price $383.15 / $525.92 / $919.44	Professional		$383.15	$525.92	$919.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.18 / $120.98 / $220.17	Professional	26	$105.18	$120.98	$220.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.54 / $411.56 / $720.76	Professional	TC	$273.54	$411.56	$720.76