Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.82 / $49.95 / $60.28	Facility	26	$43.82	$49.95	$60.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $149.99 / $279.82	Professional		$130.07	$149.99	$279.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $45.64 / $97.31	Professional	26	$41.17	$45.64	$97.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.92 / $105.50 / $174.38	Professional	TC	$93.92	$105.50	$174.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.67 / $117.94 / $143.34	Professional		$114.67	$117.94	$143.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $43.71 / $65.56	Professional	26	$34.97	$43.71	$65.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $106.00 / $106.00 / $149.44	Professional	TC	$106.00	$106.00	$149.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $169.60 / $234.04	Professional		$128.22	$169.60	$234.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.60 / $46.94 / $66.65	Professional	26	$38.60	$46.94	$66.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.63 / $120.69 / $165.38	Professional	TC	$89.63	$120.69	$165.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $114.57 / $186.34	Professional		$45.90	$114.57	$186.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.09 / $200.62 / $303.31	Professional		$143.09	$200.62	$303.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.29 / $57.78 / $94.21	Professional	26	$44.29	$57.78	$94.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.04 / $140.22 / $212.29	Professional	TC	$99.04	$140.22	$212.29
United Facility/Professional Professional Modifier Low / Median / High Price $149.46 / $190.22 / $290.13	Professional		$149.46	$190.22	$290.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.65 / $56.46 / $89.10	Professional	26	$45.65	$56.46	$89.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.37 / $132.59 / $201.03	Professional	TC	$103.37	$132.59	$201.03