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 / $134.57	Facility	26	$68.48	$71.98	$134.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.68 / $475.00 / $1,138.15	Professional		$182.68	$475.00	$1,138.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.48 / $128.47 / $264.06	Professional	26	$68.48	$128.47	$264.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $91.34 / $99.20 / $297.61	Professional	52	$91.34	$99.20	$297.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.19 / $249.00 / $502.50	Professional	TC	$114.19	$249.00	$502.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.07 / $146.66 / $256.64	Professional		$109.07	$146.66	$256.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.06 / $58.77 / $84.84	Professional	26	$52.06	$58.77	$84.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.83 / $280.43 / $512.70	Professional		$212.83	$280.43	$512.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.27 / $82.68 / $125.06	Professional	26	$70.27	$82.68	$125.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.88 / $167.72 / $400.00	Professional	TC	$141.88	$167.72	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $130.52 / $239.53	Professional		$74.84	$130.52	$239.53
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 $229.33 / $483.73 / $928.92	Professional		$229.33	$483.73	$928.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $109.69 / $172.00	Professional	26	$64.59	$109.69	$172.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.80 / $401.59 / $789.44	Professional	TC	$145.80	$401.59	$789.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $349.53	Professional		$32.34	$32.34	$349.53
United Facility/Professional Professional Modifier Low / Median / High Price $185.03 / $331.31 / $580.21	Professional		$185.03	$331.31	$580.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.83 / $79.91 / $109.71	Professional	26	$65.83	$79.91	$109.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.40 / $177.55 / $485.18	Professional	TC	$122.40	$177.55	$485.18