Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.89 / $53.57 / $95.17	Facility	26	$49.89	$53.57	$95.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.82 / $221.75 / $410.81	Professional		$126.82	$221.75	$410.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $54.39 / $173.60	Professional	26	$46.89	$54.39	$173.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.41 / $66.95 / $137.50	Professional	52	$63.41	$66.95	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.92 / $152.30 / $306.32	Professional	TC	$76.92	$152.30	$306.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.38 / $131.78 / $178.89	Professional		$88.38	$131.78	$178.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $51.10 / $61.71	Professional	26	$37.88	$51.10	$61.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.68 / $71.78 / $79.31	Professional	TC	$61.68	$71.78	$79.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $199.44 / $327.80	Professional		$152.68	$199.44	$327.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.66 / $58.32 / $90.76	Professional	26	$47.66	$58.32	$90.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.00 / $131.02 / $240.00	Professional	TC	$101.00	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $89.73 / $166.96	Professional		$52.45	$89.73	$166.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.64 / $58.64 / $58.64	Facility	26	$58.64	$58.64	$58.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.13 / $304.68 / $509.54	Professional		$159.13	$304.68	$509.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.72 / $80.20 / $123.52	Professional	26	$50.72	$80.20	$123.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.41 / $223.16 / $393.25	Professional	TC	$98.41	$223.16	$393.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $166.14	Professional		$32.34	$32.34	$166.14
United Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $224.84 / $328.71	Professional		$139.72	$224.84	$328.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.37 / $59.19 / $88.79	Professional	26	$50.37	$59.19	$88.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.09 / $175.11 / $239.80	Professional	TC	$89.09	$175.11	$239.80