Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.41 / $128.72 / $189.27	Facility	26	$110.41	$128.72	$189.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.62 / $439.65 / $617.27	Professional		$327.62	$439.65	$617.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.16 / $140.00 / $279.66	Professional	26	$105.16	$140.00	$279.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $158.22 / $175.87 / $237.50	Professional	52	$158.22	$175.87	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.80 / $269.98 / $426.00	Professional	TC	$198.80	$269.98	$426.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.48 / $249.14 / $468.96	Professional		$234.48	$249.14	$468.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.45 / $87.15 / $154.76	Professional	26	$80.45	$87.15	$154.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $157.79 / $1,079.65 / $1,079.65	Professional	TC	$157.79	$1,079.65	$1,079.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.07 / $596.44 / $864.34	Professional		$392.07	$596.44	$864.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.45 / $175.01 / $227.16	Professional	26	$122.45	$175.01	$227.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.01 / $439.78 / $659.67	Professional	TC	$269.01	$439.78	$659.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.60 / $229.48 / $381.03	Professional		$105.60	$229.48	$381.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.88 / $123.88 / $123.88	Facility	26	$123.88	$123.88	$123.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.83 / $761.07 / $1,605.38	Professional		$320.83	$761.07	$1,605.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.72 / $146.44 / $244.22	Professional	26	$102.72	$146.44	$244.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.37 / $616.55 / $1,339.21	Professional	TC	$212.37	$616.55	$1,339.21
United Facility/Professional Professional Modifier Low / Median / High Price $328.65 / $555.96 / $1,295.03	Professional		$328.65	$555.96	$1,295.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.70 / $122.84 / $236.54	Professional	26	$99.70	$122.84	$236.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.27 / $380.02 / $996.19	Professional	TC	$224.27	$380.02	$996.19