Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $79.43 / $112.20	Facility	26	$66.07	$79.43	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $302.00 / $870.96	Professional		$100.00	$302.00	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $120.23 / $354.81	Professional	26	$61.66	$120.23	$354.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $229.09 / $478.63	Professional	50	$125.89	$229.09	$478.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $100.00 / $100.00 / $223.87	Professional	52	$100.00	$100.00	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $239.88 / $562.34	Professional	TC	$141.25	$239.88	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $281.84	Professional		$147.91	$186.21	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $57.54 / $109.65	Professional	26	$47.86	$57.54	$109.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $125.89 / $263.03	Professional	TC	$102.33	$125.89	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $416.87 / $660.69	Professional		$251.19	$416.87	$660.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $97.72 / $141.25	Professional	26	$63.10	$97.72	$141.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $380.19 / $616.60 / $1,000.00	Professional	50	$380.19	$616.60	$1,000.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $309.03 / $501.19	Professional	TC	$177.83	$309.03	$501.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $158.49 / $257.04	Professional		$67.61	$158.49	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $616.60 / $912.01	Professional		$186.21	$616.60	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $165.96	Professional	26	$56.23	$89.13	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $316.23 / $724.44	Professional	TC	$138.04	$316.23	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $331.13 / $660.69	Professional		$208.93	$331.13	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $70.79 / $123.03	Professional	26	$58.88	$70.79	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $229.09 / $562.34	Professional	TC	$144.54	$229.09	$562.34