Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.48 / $71.68 / $133.97	Facility	26	$68.48	$71.68	$133.97
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.42 / $109.09 / $144.68	Facility	53	$37.42	$109.09	$144.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.11 / $370.47 / $1,138.15	Professional		$187.11	$370.47	$1,138.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $119.00 / $291.44	Professional	26	$68.48	$119.00	$291.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $93.56 / $101.66 / $212.50	Professional	52	$93.56	$101.66	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.63 / $234.88 / $441.00	Professional	TC	$118.63	$234.88	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.65 / $219.54 / $223.93	Professional		$144.65	$219.54	$223.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $64.78 / $84.47	Professional	26	$51.82	$64.78	$84.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.11 / $282.11 / $512.70	Professional		$214.11	$282.11	$512.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.43 / $81.69 / $121.95	Professional	26	$69.43	$81.69	$121.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.66 / $174.76 / $400.00	Professional	TC	$144.66	$174.76	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.80 / $133.43 / $245.88	Professional		$71.80	$133.43	$245.88
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 $235.09 / $504.82 / $991.00	Professional		$235.09	$504.82	$991.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $109.20 / $172.00	Professional	26	$64.59	$109.20	$172.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.94 / $408.30 / $846.61	Professional	TC	$151.94	$408.30	$846.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $314.84	Professional		$32.34	$32.34	$314.84
United Facility/Professional Professional Modifier Low / Median / High Price $197.18 / $306.95 / $593.35	Professional		$197.18	$306.95	$593.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.83 / $79.73 / $109.71	Professional	26	$65.83	$79.73	$109.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.68 / $197.24 / $523.63	Professional	TC	$132.68	$197.24	$523.63