Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $325.97 / $349.20 / $463.64	Professional		$325.97	$349.20	$463.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $149.78 / $169.27 / $203.05	Professional	26	$149.78	$169.27	$203.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.26 / $175.31 / $241.89	Professional	TC	$118.26	$175.31	$241.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.63 / $160.63 / $160.63	Professional		$160.63	$160.63	$160.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $243.41 / $243.41 / $243.41	Professional	26	$243.41	$243.41	$243.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.91 / $171.91 / $751.00	Professional		$171.91	$171.91	$751.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.84 / $72.84 / $173.54	Professional	26	$72.84	$72.84	$173.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.07 / $99.07 / $383.60	Professional	TC	$99.07	$99.07	$383.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $179.31 / $227.18 / $451.82	Facility		$179.31	$227.18	$451.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $146.55 / $231.78 / $418.35	Professional		$146.55	$231.78	$418.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $283.41 / $283.41 / $283.41	Facility		$283.41	$283.41	$283.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $727.89	Professional		$326.16	$326.16	$727.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $247.65	Professional	26	$153.56	$153.56	$247.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $352.18	Professional	TC	$172.60	$172.60	$352.18
United Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $417.48 / $817.21	Professional		$208.74	$417.48	$817.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.26 / $183.56 / $315.35	Professional	26	$109.26	$183.56	$315.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.44 / $211.12 / $567.83	Professional	TC	$97.44	$211.12	$567.83