Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $424.88 / $449.17 / $666.55	Facility	26	$424.88	$449.17	$666.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.64 / $1,897.12 / $2,240.86	Professional		$1,659.64	$1,897.12	$2,240.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $368.80 / $423.00 / $863.00	Professional	26	$368.80	$423.00	$863.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,249.39 / $1,449.55 / $1,745.83	Professional	TC	$1,249.39	$1,449.55	$1,745.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,417.67 / $1,417.67 / $1,417.67	Professional		$1,417.67	$1,417.67	$1,417.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $315.52 / $493.01 / $591.62	Professional	26	$315.52	$493.01	$591.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,506.71 / $1,735.24 / $2,602.86	Professional		$1,506.71	$1,735.24	$2,602.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $414.80 / $518.50 / $715.53	Professional	26	$414.80	$518.50	$715.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,095.06 / $1,216.74 / $1,825.11	Professional	TC	$1,095.06	$1,216.74	$1,825.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $420.23 / $1,464.46 / $2,084.81	Professional		$420.23	$1,464.46	$2,084.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,637.78 / $2,227.26 / $4,081.00	Professional		$1,637.78	$2,227.26	$4,081.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $437.09 / $556.29 / $936.70	Professional	26	$437.09	$556.29	$936.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,198.43 / $1,644.70 / $3,133.12	Professional	TC	$1,198.43	$1,644.70	$3,133.12
United Facility/Professional Professional Modifier Low / Median / High Price $1,656.82 / $2,147.83 / $3,567.47	Professional		$1,656.82	$2,147.83	$3,567.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $384.23 / $463.00 / $790.02	Professional	26	$384.23	$463.00	$790.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.69 / $1,650.08 / $2,839.21	Professional	TC	$1,258.69	$1,650.08	$2,839.21