Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.89 / $42.52 / $2,340.53	Facility	26	$35.89	$42.52	$2,340.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.63 / $199.26 / $391.28	Professional		$175.63	$199.26	$391.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $40.25 / $76.00	Professional	26	$31.53	$40.25	$76.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.01 / $161.72 / $255.35	Professional	TC	$139.01	$161.72	$255.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.68 / $146.97 / $252.53	Professional		$134.68	$146.97	$252.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $34.57 / $51.86	Professional	26	$27.57	$34.57	$51.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $180.60 / $180.60 / $200.67	Professional	TC	$180.60	$180.60	$200.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.75 / $225.70 / $320.49	Professional		$160.75	$225.70	$320.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $40.00 / $58.52	Professional	26	$28.27	$40.00	$58.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.47 / $183.30 / $260.27	Professional	TC	$132.47	$183.30	$260.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $153.85 / $218.58	Professional		$36.72	$153.85	$218.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.71 / $244.99 / $400.58	Professional		$181.71	$244.99	$400.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.86 / $41.47 / $78.95	Professional	26	$30.86	$41.47	$78.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.06 / $202.38 / $350.00	Professional	TC	$146.06	$202.38	$350.00
United Facility/Professional Professional Modifier Low / Median / High Price $173.02 / $242.47 / $369.32	Professional		$173.02	$242.47	$369.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.28 / $39.56 / $65.25	Professional	26	$31.28	$39.56	$65.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.27 / $206.71 / $349.44	Professional	TC	$144.27	$206.71	$349.44