Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.75 / $76.19 / $125.24	Facility	26	$65.75	$76.19	$125.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $259.58 / $630.00	Professional		$152.68	$259.58	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.75 / $107.73 / $166.53	Professional	26	$65.75	$107.73	$166.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $99.99 / $111.46 / $237.50	Professional	52	$99.99	$111.46	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.00 / $176.33 / $368.50	Professional	TC	$135.00	$176.33	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.55 / $158.97 / $226.70	Professional		$149.55	$158.97	$226.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $50.60 / $89.28	Professional	26	$47.62	$50.60	$89.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $142.82 / $683.80 / $683.80	Professional	TC	$142.82	$683.80	$683.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.10 / $412.22 / $622.21	Professional		$253.10	$412.22	$622.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $90.30 / $128.22	Professional	26	$67.90	$90.30	$128.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $379.65 / $618.33 / $933.32	Professional	50	$379.65	$618.33	$933.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.32 / $311.13 / $482.25	Professional	TC	$179.32	$311.13	$482.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $151.84 / $243.15	Professional		$62.50	$151.84	$243.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.75 / $485.59 / $926.85	Professional		$201.75	$485.59	$926.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.11 / $85.44 / $145.50	Professional	26	$61.11	$85.44	$145.50
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $343.71	Professional	50	$301.29	$301.29	$343.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.19 / $403.79 / $778.68	Professional	TC	$139.19	$403.79	$778.68
United Facility/Professional Professional Modifier Low / Median / High Price $210.15 / $373.60 / $649.94	Professional		$210.15	$373.60	$649.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $71.79 / $131.43	Professional	26	$59.82	$71.79	$131.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.82 / $228.17 / $538.92	Professional	TC	$146.82	$228.17	$538.92