Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.77 / $36.92 / $59.32	Facility	26	$30.77	$36.92	$59.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.01 / $132.49 / $237.85	Professional		$108.01	$132.49	$237.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $34.70 / $69.55	Professional	26	$29.75	$34.70	$69.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.14 / $55.41 / $68.29	Professional	52	$50.14	$55.41	$68.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.95 / $83.59 / $142.88	Professional	TC	$73.95	$83.59	$142.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $113.11 / $164.61	Professional		$85.00	$113.11	$164.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.31 / $30.58 / $45.81	Professional	26	$24.31	$30.58	$45.81
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $21.90 / $34.54 / $34.54	Professional	52	$21.90	$34.54	$34.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.52 / $98.50 / $113.66	Professional	TC	$51.52	$98.50	$113.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.25 / $105.30 / $159.79	Professional		$69.25	$105.30	$159.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.54 / $33.49 / $52.90	Professional	26	$30.54	$33.49	$52.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $71.81 / $107.71	Professional	TC	$37.00	$71.81	$107.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.49 / $87.14 / $133.82	Professional		$32.49	$87.14	$133.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.42 / $37.42 / $37.42	Facility	26	$37.42	$37.42	$37.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $136.99 / $252.48	Professional		$97.00	$136.99	$252.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.58 / $43.62 / $72.89	Professional	26	$31.58	$43.62	$72.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.28 / $91.72 / $171.71	Professional	TC	$62.28	$91.72	$171.71
United Facility/Professional Professional Modifier Low / Median / High Price $98.18 / $124.08 / $220.20	Professional		$98.18	$124.08	$220.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.46 / $35.60 / $61.87	Professional	26	$30.46	$35.60	$61.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.36 / $86.29 / $150.59	Professional	TC	$69.36	$86.29	$150.59