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 $119.46 / $220.22 / $410.53	Professional		$119.46	$220.22	$410.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.72 / $50.40 / $177.29	Professional	26	$45.72	$50.40	$177.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.20 / $147.47 / $291.63	Professional	TC	$77.20	$147.47	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.70 / $101.68 / $116.09	Professional		$95.70	$101.68	$116.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $43.74 / $56.86	Professional	26	$34.97	$43.74	$56.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.34 / $72.34 / $72.34	Professional	TC	$72.34	$72.34	$72.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.18 / $199.23 / $322.50	Professional		$149.18	$199.23	$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 $223.77 / $294.92 / $483.75	Professional	50	$223.77	$294.92	$483.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.39 / $131.02 / $240.00	Professional	TC	$101.39	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $87.48 / $162.53	Professional		$48.72	$87.48	$162.53
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 $154.84 / $294.97 / $474.83	Professional		$154.84	$294.97	$474.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $74.43 / $114.44	Professional	26	$47.33	$74.43	$114.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.80 / $216.72 / $367.51	Professional	TC	$98.80	$216.72	$367.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $150.91	Professional		$32.34	$32.34	$150.91
United Facility/Professional Professional Modifier Low / Median / High Price $145.38 / $224.63 / $315.17	Professional		$145.38	$224.63	$315.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.13 / $55.17 / $91.85	Professional	26	$46.13	$55.17	$91.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.49 / $155.41 / $232.89	Professional	TC	$95.49	$155.41	$232.89