Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $125.89 / $138.04	Facility	26	$102.33	$125.89	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $426.58 / $758.58	Professional		$331.13	$426.58	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $125.89 / $218.78	Professional	26	$97.72	$125.89	$218.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $239.88 / $251.19 / $309.03	Professional	52	$239.88	$251.19	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $302.00 / $524.81	Professional	TC	$234.42	$302.00	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $645.65	Professional		$245.47	$302.00	$645.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $97.72 / $120.23	Professional	26	$93.33	$97.72	$120.23
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $56.23 / $83.18 / $162.18	Professional	52	$56.23	$83.18	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $426.58	Professional		$257.04	$302.00	$426.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $141.25	Professional	26	$93.33	$112.20	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $190.55 / $288.40	Professional	TC	$162.18	$190.55	$288.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $213.80 / $389.05	Professional		$102.33	$213.80	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $1,584.89	Professional		$323.59	$524.81	$1,584.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $177.83 / $478.63	Professional	26	$107.15	$177.83	$478.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $331.13 / $1,096.48	Professional	TC	$208.93	$331.13	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $630.96	Professional		$288.40	$398.11	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $144.54 / $204.17	Professional	26	$100.00	$144.54	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $245.47 / $426.58	Professional	TC	$194.98	$245.47	$426.58