Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.92 / $233.45 / $323.66	Professional		$182.92	$233.45	$323.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $81.11 / $394.25	Professional	26	$60.63	$81.11	$394.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.07 / $157.72 / $183.51	Professional	TC	$146.07	$157.72	$183.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.02 / $129.13 / $172.56	Professional		$128.02	$129.13	$172.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.13 / $47.33 / $111.41	Professional	26	$37.13	$47.33	$111.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $206.98 / $268.88	Professional		$107.04	$206.98	$268.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.81 / $101.02 / $125.90	Professional	26	$80.81	$101.02	$125.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.70 / $105.96 / $139.86	Professional	TC	$22.70	$105.96	$139.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.76 / $222.28 / $337.35	Facility		$75.76	$222.28	$337.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.27 / $203.75 / $325.48	Professional		$74.27	$203.75	$325.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $283.41 / $283.41 / $283.41	Facility		$283.41	$283.41	$283.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.68 / $264.81 / $421.00	Professional		$85.68	$264.81	$421.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.28 / $80.25 / $176.39	Professional	26	$39.28	$80.25	$176.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.12 / $137.63 / $283.68	Professional	TC	$41.12	$137.63	$283.68
United Facility/Professional Professional Modifier Low / Median / High Price $168.90 / $253.15 / $476.29	Professional		$168.90	$253.15	$476.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.97 / $86.62 / $152.72	Professional	26	$51.97	$86.62	$152.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.70 / $176.81 / $331.30	Professional	TC	$102.70	$176.81	$331.30