Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.51 / $83.30 / $122.60	Facility	26	$71.51	$83.30	$122.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.33 / $323.48 / $594.00	Professional		$196.33	$323.48	$594.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.02 / $91.64 / $181.13	Professional	26	$67.02	$91.64	$181.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $95.17 / $105.26 / $237.50	Professional	52	$95.17	$105.26	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.64 / $170.71 / $368.50	Professional	TC	$116.64	$170.71	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.83 / $149.63 / $281.64	Professional		$140.83	$149.63	$281.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.06 / $53.34 / $97.62	Professional	26	$52.06	$53.34	$97.62
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $35.21 / $35.21 / $35.21	Professional	52	$35.21	$35.21	$35.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $86.30 / $659.75 / $659.75	Professional	TC	$86.30	$659.75	$659.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.10 / $419.56 / $626.86	Professional		$243.10	$419.56	$626.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.64 / $109.89 / $142.50	Professional	26	$76.64	$109.89	$142.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.83 / $308.23 / $477.75	Professional	TC	$162.83	$308.23	$477.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.33 / $132.30 / $228.84	Professional		$68.33	$132.30	$228.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.59 / $80.59 / $80.59	Facility	26	$80.59	$80.59	$80.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.63 / $485.00 / $946.66	Professional		$191.63	$485.00	$946.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $92.55 / $172.00	Professional	26	$66.81	$92.55	$172.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.80 / $391.64 / $762.83	Professional	TC	$121.80	$391.64	$762.83
United Facility/Professional Professional Modifier Low / Median / High Price $196.07 / $331.31 / $787.38	Professional		$196.07	$331.31	$787.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.25 / $79.95 / $155.72	Professional	26	$66.25	$79.95	$155.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.91 / $231.55 / $570.79	Professional	TC	$125.91	$231.55	$570.79