Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.43 / $78.51 / $2,217.90	Facility	26	$65.43	$78.51	$2,217.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.07 / $296.31 / $600.00	Professional		$142.07	$296.31	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.72 / $98.45 / $215.60	Professional	26	$63.72	$98.45	$215.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.00 / $475.00 / $475.00	Professional	50	$475.00	$475.00	$475.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $99.84 / $111.29 / $237.50	Professional	52	$99.84	$111.29	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.74 / $176.33 / $368.50	Professional	TC	$136.74	$176.33	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.38 / $186.74 / $280.11	Professional		$149.38	$186.74	$280.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $51.15 / $89.28	Professional	26	$47.62	$51.15	$89.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $142.49 / $674.05 / $674.05	Professional	TC	$142.49	$674.05	$674.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.44 / $412.22 / $622.21	Professional		$253.44	$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 $380.16 / $618.33 / $933.32	Professional	50	$380.16	$618.33	$933.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.67 / $311.13 / $482.25	Professional	TC	$179.67	$311.13	$482.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $151.49 / $242.76	Professional		$62.50	$151.49	$242.76
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 $200.32 / $494.41 / $955.02	Professional		$200.32	$494.41	$955.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $83.77 / $142.30	Professional	26	$60.73	$83.77	$142.30
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 $136.74 / $421.04 / $792.58	Professional	TC	$136.74	$421.04	$792.58
United Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $324.24 / $649.94	Professional		$197.56	$324.24	$649.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.90 / $69.69 / $142.57	Professional	26	$58.90	$69.69	$142.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.91 / $217.68 / $509.64	Professional	TC	$141.91	$217.68	$509.64