Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.79 / $49.92 / $91.22	Facility	26	$43.79	$49.92	$91.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.89 / $129.90 / $251.24	Professional		$105.89	$129.90	$251.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $45.61 / $91.22	Professional	26	$42.60	$45.61	$91.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.89 / $67.70 / $114.04	Professional	TC	$59.89	$67.70	$114.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.70 / $105.87 / $159.06	Professional		$84.70	$105.87	$159.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $52.42 / $65.54	Professional	26	$34.95	$52.42	$65.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.24 / $69.65 / $93.29	Professional	TC	$56.24	$69.65	$93.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.45 / $134.41 / $208.33	Professional		$116.45	$134.41	$208.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.16 / $60.20 / $85.48	Professional	26	$48.16	$60.20	$85.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.63 / $74.20 / $115.02	Professional	TC	$63.63	$74.20	$115.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $72.11 / $133.90	Professional		$46.42	$72.11	$133.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.62 / $53.62 / $53.62	Facility	26	$53.62	$53.62	$53.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.93 / $151.56 / $251.45	Professional		$102.93	$151.56	$251.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $62.26 / $103.64	Professional	26	$44.73	$62.26	$103.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.39 / $83.49 / $149.68	Professional	TC	$48.39	$83.49	$149.68
United Facility/Professional Professional Modifier Low / Median / High Price $105.83 / $129.88 / $217.74	Professional		$105.83	$129.88	$217.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.24 / $51.46 / $89.04	Professional	26	$42.24	$51.46	$89.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.57 / $78.15 / $131.75	Professional	TC	$62.57	$78.15	$131.75