Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $66.18 / $122.93	Facility	26	$62.89	$66.18	$122.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.77 / $375.00 / $1,189.00	Professional		$192.77	$375.00	$1,189.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.90 / $118.34 / $268.00	Professional	26	$62.90	$118.34	$268.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,218.00 / $1,218.00 / $1,218.00	Professional	50	$1,218.00	$1,218.00	$1,218.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $96.39 / $104.87 / $212.50	Professional	52	$96.39	$104.87	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.87 / $260.86 / $446.82	Professional	TC	$129.87	$260.86	$446.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.55 / $198.34 / $272.04	Professional		$149.55	$198.34	$272.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $48.33 / $77.51	Professional	26	$47.62	$48.33	$77.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.59 / $290.39 / $474.10	Professional		$221.59	$290.39	$474.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.12 / $74.09 / $104.54	Professional	26	$59.12	$74.09	$104.54
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $332.38 / $430.96 / $711.15	Professional	50	$332.38	$430.96	$711.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $156.99 / $187.85 / $400.00	Professional	TC	$156.99	$187.85	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $139.99 / $253.90	Professional		$66.45	$139.99	$253.90
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 $242.90 / $483.90 / $927.95	Professional		$242.90	$483.90	$927.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $101.22 / $155.34	Professional	26	$58.77	$101.22	$155.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.52 / $394.87 / $796.59	Professional	TC	$166.52	$394.87	$796.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $297.67	Professional		$32.34	$32.34	$297.67
United Facility/Professional Professional Modifier Low / Median / High Price $210.03 / $326.89 / $573.34	Professional		$210.03	$326.89	$573.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.65 / $73.81 / $98.52	Professional	26	$58.65	$73.81	$98.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.05 / $281.64 / $494.95	Professional	TC	$146.05	$281.64	$494.95