Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.12 / $47.12 / $55.70	Facility	26	$47.12	$47.12	$55.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $151.71 / $174.65	Professional		$133.29	$151.71	$174.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.26 / $47.12 / $57.39	Professional	26	$44.26	$47.12	$57.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.78 / $106.59 / $127.76	Professional	TC	$89.78	$106.59	$127.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.64 / $183.60 / $183.60	Professional		$105.64	$183.60	$183.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.11 / $60.11 / $60.11	Professional	26	$60.11	$60.11	$60.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.97 / $245.50 / $351.81	Professional		$118.97	$245.50	$351.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.81 / $70.59 / $101.92	Professional	26	$48.81	$70.59	$101.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.16 / $178.60 / $249.88	Professional	TC	$70.16	$178.60	$249.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.57 / $97.97 / $153.00	Professional		$42.57	$97.97	$153.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $224.22 / $369.98	Professional		$134.38	$224.22	$369.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $62.45 / $97.93	Professional	26	$45.02	$62.45	$97.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.57 / $154.84 / $222.40	Professional	TC	$90.57	$154.84	$222.40
United Facility/Professional Professional Modifier Low / Median / High Price $123.21 / $178.53 / $290.37	Professional		$123.21	$178.53	$290.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.19 / $50.74 / $93.01	Professional	26	$40.19	$50.74	$93.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.76 / $110.39 / $211.25	Professional	TC	$78.76	$110.39	$211.25