Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.48 / $70.48 / $108.38	Facility	26	$70.48	$70.48	$108.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.49 / $328.75 / $522.50	Professional		$235.49	$328.75	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.51 / $89.49 / $153.03	Professional	26	$67.51	$89.49	$153.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $114.20 / $126.45 / $237.50	Professional	52	$114.20	$126.45	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.17 / $227.21 / $340.00	Professional	TC	$164.17	$227.21	$340.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.51 / $177.98 / $209.39	Professional		$167.51	$177.98	$209.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.46 / $65.50 / $96.20	Professional	26	$51.46	$65.50	$96.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.97 / $162.69 / $185.20	Professional	TC	$112.97	$162.69	$185.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.87 / $380.21 / $589.32	Professional		$338.87	$380.21	$589.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.70 / $69.80 / $108.19	Professional	26	$62.70	$69.80	$108.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $282.76 / $310.41 / $481.13	Professional	TC	$282.76	$310.41	$481.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $167.05 / $272.20	Professional		$67.34	$167.05	$272.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Facility	26	$79.45	$79.45	$79.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.17 / $518.66 / $875.42	Professional		$233.17	$518.66	$875.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.59 / $90.28 / $152.53	Professional	26	$65.59	$90.28	$152.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.13 / $429.11 / $740.29	Professional	TC	$160.13	$429.11	$740.29
United Facility/Professional Professional Modifier Low / Median / High Price $248.96 / $425.62 / $675.83	Professional		$248.96	$425.62	$675.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.81 / $78.81 / $146.24	Professional	26	$63.81	$78.81	$146.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $175.72 / $312.38 / $629.54	Professional	TC	$175.72	$312.38	$629.54