Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $245.47	Professional		$63.10	$89.13	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $70.79 / $269.15	Professional	26	$26.92	$70.79	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $57.54 / $173.78	Professional	TC	$43.65	$57.54	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $112.20	Professional		$51.29	$64.57	$112.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.39 / $47.86	Professional	26	$15.85	$22.39	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $75.86	Professional		$45.71	$45.71	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $50.12	Professional	26	$16.22	$16.22	$50.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $29.51 / $47.86	Professional	TC	$29.51	$29.51	$47.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $81.28 / $125.89	Facility		$31.62	$81.28	$125.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $87.10 / $138.04	Professional		$34.67	$87.10	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $125.89 / $229.09	Facility		$53.70	$125.89	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $93.33 / $190.55	Professional		$40.74	$93.33	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $33.11 / $95.50	Professional	26	$16.60	$33.11	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $54.95 / $125.89	Professional	TC	$15.85	$54.95	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $52.48 / $87.10	Facility		$34.67	$52.48	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $100.00 / $181.97	Professional		$63.10	$100.00	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $38.90 / $64.57	Professional	26	$21.88	$38.90	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $63.10 / $117.49	Professional	TC	$38.02	$63.10	$117.49