Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.95 / $114.13 / $169.54	Facility	26	$107.95	$114.13	$169.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.12 / $147.04 / $224.00	Professional		$131.12	$147.04	$224.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.51 / $106.28 / $198.00	Professional	26	$96.51	$106.28	$198.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.77 / $32.90 / $100.62	Professional	TC	$30.77	$32.90	$100.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.26 / $125.40 / $150.47	Professional	26	$80.26	$125.40	$150.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.69 / $323.44 / $517.50	Professional		$161.69	$323.44	$517.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.16 / $137.69 / $190.02	Professional	26	$110.16	$137.69	$190.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.00 / $185.74 / $297.18	Professional	TC	$48.00	$185.74	$297.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.34 / $114.77 / $168.66	Professional		$36.34	$114.77	$168.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.93 / $539.00 / $1,041.26	Professional		$169.93	$539.00	$1,041.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.50 / $142.01 / $241.63	Professional	26	$113.50	$142.01	$241.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.32 / $423.66 / $792.94	Professional	TC	$40.32	$423.66	$792.94
United Facility/Professional Professional Modifier Low / Median / High Price $129.30 / $187.36 / $975.39	Professional		$129.30	$187.36	$975.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.40 / $117.95 / $201.08	Professional	26	$96.40	$117.95	$201.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $44.59 / $413.29	Professional	TC	$23.47	$44.59	$413.29