Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $72.44 / $123.03	Facility	26	$67.61	$72.44	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $1,348.96	Professional		$194.98	$426.58	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $120.23 / $288.40	Professional	26	$67.61	$120.23	$288.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $190.55 / $190.55	Professional	52	$123.03	$190.55	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $234.42 / $562.34	Professional	TC	$123.03	$234.42	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $363.08	Professional		$131.83	$169.82	$363.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $128.82	Professional	26	$52.48	$72.44	$128.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $95.50 / $158.49	Professional	TC	$87.10	$95.50	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $724.44	Professional		$245.47	$309.03	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $85.11 / $151.36	Professional	26	$79.43	$85.11	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $173.78 / $575.44	Professional	TC	$162.18	$173.78	$575.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $229.09	Professional		$72.44	$125.89	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $660.69 / $2,187.76	Professional		$223.87	$660.69	$2,187.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $134.90 / $380.19	Professional	26	$69.18	$134.90	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $467.74 / $1,445.44	Professional	TC	$141.25	$467.74	$1,445.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $416.87 / $575.44	Professional		$199.53	$416.87	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.28 / $117.49	Professional	26	$67.61	$81.28	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $309.03 / $478.63	Professional	TC	$125.89	$309.03	$478.63