Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.41 / $97.41 / $158.93	Facility	26	$97.41	$97.41	$158.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.81 / $346.01 / $568.13	Professional		$312.81	$346.01	$568.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.41 / $103.24 / $157.30	Professional	26	$97.41	$103.24	$157.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $239.33 / $239.33 / $251.44	Professional	52	$239.33	$239.33	$251.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $206.93 / $243.59 / $343.46	Professional	TC	$206.93	$243.59	$343.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $389.51 / $389.51 / $389.51	Professional		$389.51	$389.51	$389.51
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $72.56 / $72.56 / $72.56	Professional	52	$72.56	$72.56	$72.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $279.08 / $348.87 / $481.44	Professional		$279.08	$348.87	$481.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.15 / $109.71 / $170.38	Professional	26	$87.15	$109.71	$170.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.83 / $219.79 / $303.31	Professional	TC	$175.83	$219.79	$303.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $243.18 / $381.88	Professional		$98.74	$243.18	$381.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.13 / $379.99 / $725.55	Professional		$298.13	$379.99	$725.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.27 / $130.44 / $218.42	Professional	26	$101.27	$130.44	$218.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.95 / $252.99 / $487.91	Professional	TC	$185.95	$252.99	$487.91
United Facility/Professional Professional Modifier Low / Median / High Price $293.82 / $378.53 / $650.14	Professional		$293.82	$378.53	$650.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.08 / $127.55 / $204.39	Professional	26	$100.08	$127.55	$204.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.47 / $259.47 / $430.03	Professional	TC	$190.47	$259.47	$430.03