Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $49.74 / $87.65	Facility	26	$45.71	$49.74	$87.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $219.23 / $410.53	Professional		$139.19	$219.23	$410.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.72 / $51.28 / $182.61	Professional	26	$45.72	$51.28	$182.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.48 / $177.61 / $308.00	Professional	TC	$93.48	$177.61	$308.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.01 / $156.12 / $205.64	Professional		$118.01	$156.12	$205.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $48.11 / $54.68	Professional	26	$34.99	$48.11	$54.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $202.45 / $322.50	Professional		$153.65	$202.45	$322.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.50 / $55.88 / $88.90	Professional	26	$47.50	$55.88	$88.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $230.48 / $303.68 / $483.75	Professional	50	$230.48	$303.68	$483.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.16 / $131.02 / $240.00	Professional	TC	$106.16	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.27 / $113.88 / $199.88	Professional		$50.27	$113.88	$199.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.58 / $294.97 / $494.46	Professional		$191.58	$294.97	$494.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $74.43 / $115.16	Professional	26	$47.33	$74.43	$115.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.40 / $218.84 / $373.76	Professional	TC	$135.40	$218.84	$373.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $178.22	Professional		$32.34	$32.34	$178.22
United Facility/Professional Professional Modifier Low / Median / High Price $160.16 / $225.98 / $321.45	Professional		$160.16	$225.98	$321.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.41 / $56.49 / $76.88	Professional	26	$47.41	$56.49	$76.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $113.34 / $170.81 / $245.01	Professional	TC	$113.34	$170.81	$245.01