Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.55 / $66.55 / $106.61	Facility	26	$66.55	$66.55	$106.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.44 / $232.98 / $342.95	Professional		$215.44	$232.98	$342.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.52 / $69.51 / $118.58	Professional	26	$62.52	$69.51	$118.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $166.43 / $240.05	Professional	TC	$152.75	$166.43	$240.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.53 / $207.11 / $291.98	Professional		$169.53	$207.11	$291.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.01 / $60.01 / $84.60	Professional	26	$60.01	$60.01	$84.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.55 / $271.69 / $386.12	Professional		$203.55	$271.69	$386.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $88.63 / $127.98	Professional	26	$68.73	$88.63	$127.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.81 / $185.10 / $255.43	Professional	TC	$134.81	$185.10	$255.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.22 / $159.00 / $244.70	Professional		$59.22	$159.00	$244.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.50 / $69.50 / $69.50	Facility	26	$69.50	$69.50	$69.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.11 / $285.45 / $462.28	Professional		$223.11	$285.45	$462.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.19 / $86.08 / $132.11	Professional	26	$63.19	$86.08	$132.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.63 / $192.04 / $332.81	Professional	TC	$153.63	$192.04	$332.81
United Facility/Professional Professional Modifier Low / Median / High Price $200.34 / $242.47 / $439.02	Professional		$200.34	$242.47	$439.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.63 / $73.05 / $133.12	Professional	26	$56.63	$73.05	$133.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.15 / $177.31 / $322.63	Professional	TC	$141.15	$177.31	$322.63