Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $562.34 / $691.83	Facility	26	$501.19	$562.34	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,041.74 / $4,677.35	Professional		$1,621.81	$2,041.74	$4,677.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $562.34 / $1,174.90	Professional	26	$371.54	$562.34	$1,174.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,548.82 / $2,818.38	Professional	TC	$1,202.26	$1,548.82	$2,818.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $2,754.23	Professional		$1,380.38	$1,479.11	$2,754.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $416.87 / $588.84	Professional	26	$323.59	$416.87	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $3,090.30	Professional		$1,737.80	$1,737.80	$3,090.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $512.86 / $851.14	Professional	26	$436.52	$512.86	$851.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,230.27 / $1,288.25 / $2,187.76	Professional	TC	$1,230.27	$1,288.25	$2,187.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $1,513.56 / $2,137.96	Professional		$436.52	$1,513.56	$2,137.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $2,238.72 / $3,801.89	Professional		$616.60	$2,238.72	$3,801.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $549.54 / $933.25	Professional	26	$436.52	$549.54	$933.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,737.80 / $3,019.95	Professional	TC	$1,202.26	$1,737.80	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $3,388.44	Professional		$1,698.24	$2,137.96	$3,388.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $457.09 / $741.31	Professional	26	$380.19	$457.09	$741.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,659.59 / $2,630.27	Professional	TC	$1,318.26	$1,659.59	$2,630.27