Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.51 / $80.41 / $132.65	Facility	26	$67.51	$80.41	$132.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.39 / $475.00 / $971.50	Professional		$218.39	$475.00	$971.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.51 / $126.71 / $263.00	Professional	26	$67.51	$126.71	$263.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $109.20 / $118.33 / $269.19	Professional	52	$109.20	$118.33	$269.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $150.87 / $306.76 / $485.75	Professional	TC	$150.87	$306.76	$485.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.51 / $173.78 / $177.98	Professional		$167.51	$173.78	$177.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.46 / $75.45 / $80.41	Professional	26	$51.46	$75.45	$80.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.13 / $372.75 / $519.80	Professional		$286.13	$372.75	$519.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.70 / $79.13 / $113.05	Professional	26	$62.70	$79.13	$113.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $217.51 / $291.24 / $400.00	Professional	TC	$217.51	$291.24	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $159.22 / $283.91	Professional		$70.76	$159.22	$283.91
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 $274.14 / $563.38 / $980.58	Professional		$274.14	$563.38	$980.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.46 / $102.56 / $166.60	Professional	26	$63.46	$102.56	$166.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.84 / $450.26 / $838.74	Professional	TC	$191.84	$450.26	$838.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $313.07	Professional		$32.34	$32.34	$313.07
United Facility/Professional Professional Modifier Low / Median / High Price $241.09 / $410.58 / $591.28	Professional		$241.09	$410.58	$591.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.31 / $78.80 / $105.10	Professional	26	$65.31	$78.80	$105.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.05 / $273.33 / $518.05	Professional	TC	$162.05	$273.33	$518.05