Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.60 / $66.18 / $122.93	Facility	26	$62.60	$66.18	$122.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.47 / $366.47 / $1,141.61	Professional		$192.47	$366.47	$1,141.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.60 / $114.69 / $306.00	Professional	26	$62.60	$114.69	$306.00
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 $96.24 / $104.71 / $212.50	Professional	52	$96.24	$104.71	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.87 / $268.52 / $570.75	Professional	TC	$129.87	$268.52	$570.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.32 / $198.03 / $230.86	Professional		$149.32	$198.03	$230.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $53.67 / $77.51	Professional	26	$47.62	$53.67	$77.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $121.45 / $121.45 / $142.46	Professional	TC	$121.45	$121.45	$142.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.89 / $289.52 / $474.10	Professional		$221.89	$289.52	$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 $332.83 / $434.30 / $711.15	Professional	50	$332.83	$434.30	$711.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.30 / $187.85 / $400.00	Professional	TC	$157.30	$187.85	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $139.66 / $253.50	Professional		$66.45	$139.66	$253.50
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 $242.52 / $494.41 / $954.78	Professional		$242.52	$494.41	$954.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $96.21 / $155.34	Professional	26	$58.77	$96.21	$155.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.14 / $415.72 / $831.75	Professional	TC	$166.14	$415.72	$831.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $304.04	Professional		$32.34	$32.34	$304.04
United Facility/Professional Professional Modifier Low / Median / High Price $213.98 / $403.80 / $541.14	Professional		$213.98	$403.80	$541.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.93 / $72.58 / $99.89	Professional	26	$59.93	$72.58	$99.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.79 / $228.38 / $468.04	Professional	TC	$146.79	$228.38	$468.04