Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.28 / $101.28 / $171.01	Facility	26	$101.28	$101.28	$171.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.68 / $370.84 / $661.29	Professional		$304.68	$370.84	$661.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.84 / $129.53 / $231.97	Professional	26	$96.84	$129.53	$231.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.01 / $237.71 / $335.00	Professional	TC	$214.01	$237.71	$335.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.20 / $272.16 / $351.68	Professional		$251.20	$272.16	$351.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.79 / $82.56 / $151.79	Professional	26	$80.79	$82.56	$151.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $601.25 / $601.25 / $601.25	Professional	TC	$601.25	$601.25	$601.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.67 / $381.03 / $590.59	Professional		$296.67	$381.03	$590.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.44 / $112.16 / $173.84	Professional	26	$90.44	$112.16	$173.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $206.23 / $268.88 / $416.76	Professional	TC	$206.23	$268.88	$416.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $244.73 / $408.20	Professional		$106.25	$244.73	$408.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.73 / $471.01 / $746.55	Professional		$332.73	$471.01	$746.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.20 / $135.36 / $232.26	Professional	26	$103.20	$135.36	$232.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.54 / $327.05 / $514.29	Professional	TC	$229.54	$327.05	$514.29
United Facility/Professional Professional Modifier Low / Median / High Price $363.46 / $646.14 / $1,205.56	Professional		$363.46	$646.14	$1,205.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.03 / $114.12 / $235.30	Professional	26	$79.03	$114.12	$235.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.08 / $481.75 / $949.78	Professional	TC	$260.08	$481.75	$949.78