Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $91.20 / $123.03	Facility	26	$70.79	$91.20	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $363.08 / $1,148.15	Professional		$194.98	$363.08	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $117.49 / $263.03	Professional	26	$66.07	$117.49	$263.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $173.78 / $199.53	Professional	52	$123.03	$173.78	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $213.80 / $478.63	Professional	TC	$123.03	$213.80	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $288.40	Professional		$141.25	$169.82	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $58.88 / $112.20	Professional	26	$52.48	$58.88	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $218.78	Professional	TC	$79.43	$93.33	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $426.58 / $691.83	Professional		$245.47	$426.58	$691.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $120.23 / $162.18	Professional	26	$79.43	$120.23	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $309.03 / $501.19	Professional	TC	$162.18	$309.03	$501.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $138.04 / $239.88	Professional		$74.13	$138.04	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $691.83 / $954.99	Professional		$194.98	$691.83	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $100.00 / $181.97	Professional	26	$61.66	$100.00	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $295.12 / $676.08	Professional	TC	$120.23	$295.12	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $676.08	Professional		$199.53	$331.13	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $138.04	Professional	26	$64.57	$81.28	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $208.93 / $549.54	Professional	TC	$128.82	$208.93	$549.54