Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $38.90 / $53.70	Facility	26	$30.20	$38.90	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $380.19	Professional		$107.15	$162.18	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $93.33	Professional	26	$26.92	$42.66	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $100.00 / $173.78	Professional	TC	$77.62	$100.00	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $190.55	Professional		$91.20	$141.25	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.20 / $44.67	Professional	26	$23.99	$30.20	$44.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $95.50 / $117.49	Professional	TC	$85.11	$95.50	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $177.83	Professional		$67.61	$114.82	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $35.48 / $57.54	Professional	26	$31.62	$35.48	$57.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $77.62 / $123.03	Professional	TC	$35.48	$77.62	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $165.96 / $229.09	Professional		$33.11	$165.96	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $177.83 / $371.54	Professional		$104.71	$177.83	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $72.44	Professional	26	$26.92	$42.66	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $134.90 / $295.12	Professional	TC	$69.18	$134.90	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $239.88	Professional		$100.00	$147.91	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $36.31 / $56.23	Professional	26	$28.18	$36.31	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $112.20 / $194.98	Professional	TC	$67.61	$112.20	$194.98