Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $54.95 / $72.44	Facility	26	$38.90	$54.95	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $251.19 / $676.08	Professional		$128.82	$251.19	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $61.66 / $194.98	Professional	26	$38.90	$61.66	$194.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	52	$194.98	$194.98	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $151.36 / $288.40	Professional	TC	$87.10	$151.36	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $239.88	Professional		$89.13	$104.71	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $41.69 / $74.13	Professional	26	$30.20	$41.69	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $95.50 / $158.49	Professional	TC	$69.18	$95.50	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $186.21 / $436.52	Professional		$165.96	$186.21	$436.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.10 / $104.71	Professional	26	$53.70	$63.10	$104.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $125.89 / $331.13	Professional	TC	$109.65	$125.89	$331.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $154.88	Professional		$41.69	$87.10	$154.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $338.84 / $1,047.13	Professional		$151.36	$338.84	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $81.28 / $269.15	Professional	26	$40.74	$81.28	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $229.09 / $724.44	Professional	TC	$95.50	$229.09	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $302.00	Professional		$125.89	$218.78	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $54.95 / $81.28	Professional	26	$39.81	$54.95	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $162.18 / $229.09	Professional	TC	$85.11	$162.18	$229.09