Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $174.84 / $174.84 / $235.92	Facility	26	$174.84	$174.84	$235.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.47 / $288.05 / $401.21	Professional		$259.47	$288.05	$401.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $164.37 / $176.39 / $215.35	Professional	26	$164.37	$176.39	$215.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.36 / $105.92 / $129.86	Professional	TC	$91.36	$105.92	$129.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $241.87 / $364.11 / $405.15	Professional		$241.87	$364.11	$405.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $158.37 / $215.40 / $267.10	Professional	26	$158.37	$215.40	$267.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $236.48 / $302.83 / $480.99	Professional		$236.48	$302.83	$480.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $149.46 / $188.80 / $299.86	Professional	26	$149.46	$188.80	$299.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $114.04 / $181.12	Professional	TC	$87.02	$114.04	$181.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $94.27 / $195.94 / $325.10	Professional		$94.27	$195.94	$325.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.31 / $370.06 / $597.10	Professional		$292.31	$370.06	$597.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $189.28 / $233.05 / $387.84	Professional	26	$189.28	$233.05	$387.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.23 / $140.25 / $209.27	Professional	TC	$99.23	$140.25	$209.27
United Facility/Professional Professional Modifier Low / Median / High Price $257.61 / $320.50 / $529.04	Professional		$257.61	$320.50	$529.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $161.44 / $198.27 / $326.64	Professional	26	$161.44	$198.27	$326.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.57 / $120.83 / $194.38	Professional	TC	$96.57	$120.83	$194.38