Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $143.80 / $375.94	Professional		$119.70	$143.80	$375.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.79 / $31.70 / $233.65	Professional	26	$28.79	$31.70	$233.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.78 / $101.17 / $296.42	Professional	TC	$75.78	$101.17	$296.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.62 / $78.55 / $81.81	Professional		$73.62	$78.55	$81.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $17.60 / $26.45	Professional	26	$17.60	$17.60	$26.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $51.77 / $89.62	Professional		$51.77	$51.77	$89.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.42 / $16.42 / $32.65	Professional	26	$16.42	$16.42	$32.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $35.35 / $56.96	Professional	TC	$35.35	$35.35	$56.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.90 / $144.77 / $202.61	Facility		$35.90	$144.77	$202.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $132.69 / $194.81	Professional		$35.20	$132.69	$194.81
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 $52.75 / $121.51 / $231.29	Professional		$52.75	$121.51	$231.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $32.58 / $61.01	Professional	26	$18.54	$32.58	$61.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $78.76 / $181.36	Professional	TC	$34.15	$78.76	$181.36
United Facility/Professional Professional Modifier Low / Median / High Price $104.54 / $161.76 / $296.02	Professional		$104.54	$161.76	$296.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $40.06 / $69.73	Professional	26	$24.04	$40.06	$69.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.00 / $122.98 / $230.08	Professional	TC	$68.00	$122.98	$230.08