Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.48 / $71.98 / $133.97	Facility	26	$68.48	$71.98	$133.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.09 / $425.00 / $1,111.50	Professional		$182.09	$425.00	$1,111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $135.61 / $240.00	Professional	26	$68.48	$135.61	$240.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $91.05 / $98.88 / $276.29	Professional	52	$91.05	$98.88	$276.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.60 / $214.43 / $453.84	Professional	TC	$113.60	$214.43	$453.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.58 / $149.12 / $217.43	Professional		$106.58	$149.12	$217.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $70.26 / $84.84	Professional	26	$52.21	$70.26	$84.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $105.27 / $105.27 / $105.27	Professional	TC	$105.27	$105.27	$105.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.56 / $280.08 / $521.10	Professional		$212.56	$280.08	$521.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.00 / $82.36 / $131.76	Professional	26	$70.00	$82.36	$131.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.51 / $167.72 / $400.00	Professional	TC	$141.51	$167.72	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.79 / $130.52 / $238.74	Professional		$71.79	$130.52	$238.74
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 Professional Modifier Low / Median / High Price $228.56 / $475.15 / $916.89	Professional		$228.56	$475.15	$916.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.61 / $110.29 / $181.78	Professional	26	$69.61	$110.29	$181.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.41 / $383.73 / $753.46	Professional	TC	$145.41	$383.73	$753.46
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 $198.46 / $404.24 / $580.15	Professional		$198.46	$404.24	$580.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.93 / $83.77 / $144.53	Professional	26	$68.93	$83.77	$144.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.35 / $189.23 / $467.87	Professional	TC	$129.35	$189.23	$467.87