Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.12 / $59.41 / $106.34	Facility	26	$52.12	$59.41	$106.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.91 / $263.98 / $383.22	Professional		$236.91	$263.98	$383.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.12 / $73.70 / $110.53	Professional	26	$52.12	$73.70	$110.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $196.93 / $297.50	Professional	TC	$162.34	$196.93	$297.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.11 / $252.57 / $304.39	Professional		$183.11	$252.57	$304.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $46.53 / $75.17	Professional	26	$39.95	$46.53	$75.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $160.82 / $160.82 / $160.82	Professional	TC	$160.82	$160.82	$160.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.15 / $334.00 / $458.24	Professional		$217.15	$334.00	$458.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.00 / $96.83 / $146.19	Professional	26	$72.00	$96.83	$146.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.44 / $230.70 / $327.58	Professional	TC	$132.44	$230.70	$327.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.24 / $211.65 / $304.14	Professional		$53.24	$211.65	$304.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.58 / $62.58 / $62.58	Facility	26	$62.58	$62.58	$62.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.42 / $353.29 / $580.99	Professional		$261.42	$353.29	$580.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.08 / $92.91 / $151.72	Professional	26	$56.08	$92.91	$151.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.76 / $272.20 / $441.48	Professional	TC	$192.76	$272.20	$441.48
United Facility/Professional Professional Modifier Low / Median / High Price $245.84 / $341.76 / $542.51	Professional		$245.84	$341.76	$542.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.18 / $80.27 / $132.18	Professional	26	$51.18	$80.27	$132.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.66 / $269.80 / $407.79	Professional	TC	$194.66	$269.80	$407.79