Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.51 / $85.82 / $3,060.00	Facility	26	$71.51	$85.82	$3,060.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.24 / $105.75 / $185.00	Facility	53	$40.24	$105.75	$185.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.07 / $280.50 / $522.50	Professional		$188.07	$280.50	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.52 / $91.29 / $171.20	Professional	26	$66.52	$91.29	$171.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.14 / $107.89 / $237.50	Professional	52	$97.14	$107.89	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.66 / $176.84 / $368.50	Professional	TC	$129.66	$176.84	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.65 / $153.69 / $219.54	Professional		$144.65	$153.69	$219.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $55.76 / $97.17	Professional	26	$51.82	$55.76	$97.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $90.24 / $700.05 / $700.05	Professional	TC	$90.24	$700.05	$700.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.55 / $419.92 / $627.41	Professional		$244.55	$419.92	$627.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.64 / $109.89 / $142.50	Professional	26	$76.64	$109.89	$142.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.24 / $308.58 / $478.31	Professional	TC	$165.24	$308.58	$478.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $138.33 / $235.05	Professional		$68.02	$138.33	$235.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.11 / $45.11 / $45.11	Facility	53	$45.11	$45.11	$45.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.49 / $514.80 / $977.21	Professional		$196.49	$514.80	$977.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.52 / $92.93 / $172.00	Professional	26	$66.52	$92.93	$172.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.66 / $418.50 / $790.54	Professional	TC	$126.66	$418.50	$790.54
United Facility/Professional Professional Modifier Low / Median / High Price $197.18 / $339.05 / $742.62	Professional		$197.18	$339.05	$742.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.64 / $79.98 / $143.29	Professional	26	$65.64	$79.98	$143.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.44 / $240.78 / $591.48	Professional	TC	$135.44	$240.78	$591.48