Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.31 / $82.43 / $121.74	Facility	26	$62.31	$82.43	$121.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.89 / $475.00 / $1,495.17	Professional		$212.89	$475.00	$1,495.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.31 / $113.05 / $322.00	Professional	26	$62.31	$113.05	$322.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $712.50	Professional	50	$712.50	$712.50	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $150.58 / $306.13 / $560.77	Professional	TC	$150.58	$306.13	$560.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.34 / $173.55 / $215.96	Professional		$163.34	$173.55	$215.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.38 / $49.77 / $74.18	Professional	26	$47.38	$49.77	$74.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $279.02 / $365.88 / $477.36	Professional		$279.02	$365.88	$477.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $72.47 / $102.34	Professional	26	$56.20	$72.47	$102.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $418.55 / $548.82 / $716.05	Professional	50	$418.55	$548.82	$716.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $215.85 / $291.24 / $400.00	Professional	TC	$215.85	$291.24	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $158.90 / $276.51	Professional		$65.56	$158.90	$276.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.07 / $546.90 / $962.90	Professional		$267.07	$546.90	$962.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $94.70 / $152.66	Professional	26	$58.77	$94.70	$152.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.46 / $446.39 / $831.53	Professional	TC	$191.46	$446.39	$831.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $346.87	Professional		$32.34	$32.34	$346.87
United Facility/Professional Professional Modifier Low / Median / High Price $233.64 / $367.24 / $573.34	Professional		$233.64	$367.24	$573.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.66 / $72.29 / $99.41	Professional	26	$58.66	$72.29	$99.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.40 / $298.61 / $513.28	Professional	TC	$168.40	$298.61	$513.28