Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.28 / $48.22 / $76.56	Facility	26	$41.28	$48.22	$76.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $163.41 / $266.81	Professional		$122.40	$163.41	$266.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.67 / $49.17 / $97.94	Professional	26	$37.67	$49.17	$97.94
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.70 / $69.78 / $126.54	Professional	52	$60.70	$69.78	$126.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.95 / $107.69 / $208.96	Professional	TC	$81.95	$107.69	$208.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.20 / $117.75 / $188.40	Professional		$94.20	$117.75	$188.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.13 / $34.47 / $56.51	Professional	26	$30.13	$34.47	$56.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $108.11 / $471.25 / $471.25	Professional	TC	$108.11	$471.25	$471.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.48 / $253.50 / $375.28	Professional		$182.48	$253.50	$375.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.53 / $79.64 / $101.98	Professional	26	$57.53	$79.64	$101.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.25 / $168.22 / $260.74	Professional	TC	$121.25	$168.22	$260.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $95.17 / $153.08	Professional		$39.54	$95.17	$153.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.27 / $46.27 / $46.27	Facility	26	$46.27	$46.27	$46.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.53 / $264.76 / $473.03	Professional		$125.53	$264.76	$473.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.71 / $65.73 / $119.38	Professional	26	$39.71	$65.73	$119.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.81 / $191.42 / $352.01	Professional	TC	$85.81	$191.42	$352.01
United Facility/Professional Professional Modifier Low / Median / High Price $125.11 / $223.27 / $347.93	Professional		$125.11	$223.27	$347.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.63 / $54.56 / $94.01	Professional	26	$39.63	$54.56	$94.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.32 / $146.16 / $282.99	Professional	TC	$86.32	$146.16	$282.99