Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.64 / $38.34 / $46.88	Facility	26	$33.64	$38.34	$46.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $124.76 / $242.00	Professional		$108.47	$124.76	$242.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.74 / $35.22 / $86.63	Professional	26	$31.74	$35.22	$86.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.43 / $238.00 / $244.00	Professional	52	$40.43	$238.00	$244.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $87.55 / $143.97	Professional	TC	$78.81	$87.55	$143.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.82 / $98.63 / $185.65	Professional		$92.82	$98.63	$185.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $28.53 / $50.34	Professional	26	$26.85	$28.53	$50.34
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $22.65 / $25.12 / $32.49	Professional	52	$22.65	$25.12	$32.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $123.71 / $123.71	Professional	TC	$65.98	$123.71	$123.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.02 / $142.22 / $209.85	Professional		$109.02	$142.22	$209.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $39.50 / $56.09	Professional	26	$31.98	$39.50	$56.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.04 / $102.73 / $148.75	Professional	TC	$77.04	$102.73	$148.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $98.24 / $150.84	Professional		$35.24	$98.24	$150.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	26	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.27 / $161.87 / $247.33	Professional		$115.27	$161.87	$247.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.17 / $44.07 / $72.33	Professional	26	$34.17	$44.07	$72.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.67 / $115.85 / $175.54	Professional	TC	$81.67	$115.85	$175.54
United Facility/Professional Professional Modifier Low / Median / High Price $118.09 / $153.24 / $236.83	Professional		$118.09	$153.24	$236.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $44.12 / $70.81	Professional	26	$34.22	$44.12	$70.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.97 / $110.56 / $175.00	Professional	TC	$86.97	$110.56	$175.00