Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $257.04	Professional		$75.86	$104.71	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $91.20 / $354.81	Professional	26	$33.11	$91.20	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $66.07 / $112.20	Professional	TC	$41.69	$66.07	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $24.55 / $57.54	Professional	26	$19.05	$24.55	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $56.23 / $97.72	Professional		$50.12	$56.23	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $53.70	Professional	26	$20.42	$20.42	$53.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $35.48 / $60.26	Professional	TC	$30.20	$35.48	$60.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $85.11 / $134.90	Facility		$38.02	$85.11	$134.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $144.54	Professional		$41.69	$87.10	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $112.20 / $199.53	Professional		$54.95	$112.20	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $39.81 / $95.50	Professional	26	$19.95	$39.81	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $61.66 / $131.83	Professional	TC	$21.38	$61.66	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $67.61 / $114.82	Facility		$45.71	$67.61	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $117.49 / $218.78	Professional		$74.13	$117.49	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $47.86 / $79.43	Professional	26	$26.30	$47.86	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $74.13 / $138.04	Professional	TC	$45.71	$74.13	$138.04