Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $125.24 / $196.89	Professional		$103.70	$125.24	$196.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.36 / $66.56 / $304.56	Professional	26	$52.36	$66.56	$304.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.97 / $71.73 / $81.73	Professional	TC	$64.97	$71.73	$81.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.69 / $74.69 / $100.26	Professional		$74.69	$74.69	$100.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $31.74 / $95.21	Professional	26	$31.59	$31.74	$95.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.04 / $63.21 / $83.43	Professional		$43.04	$63.21	$83.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.95 / $29.95 / $65.64	Professional	26	$29.95	$29.95	$65.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.09 / $33.26 / $39.24	Professional	TC	$13.09	$33.26	$39.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.73 / $110.98 / $202.74	Facility		$64.73	$110.98	$202.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.47 / $101.73 / $196.83	Professional		$63.47	$101.73	$196.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.47 / $49.47 / $49.47	Facility		$49.47	$49.47	$49.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.95 / $148.32 / $267.93	Professional		$61.95	$148.32	$267.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $66.56 / $151.30	Professional	26	$33.31	$66.56	$151.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $61.31 / $141.12	Professional	TC	$25.41	$61.31	$141.12
United Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $148.32 / $267.50	Professional		$94.41	$148.32	$267.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.39 / $73.76 / $125.77	Professional	26	$44.39	$73.76	$125.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.02 / $75.51 / $141.72	Professional	TC	$50.02	$75.51	$141.72