Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $42.66 / $53.70	Facility	26	$33.88	$42.66	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $190.55 / $354.81	Professional		$107.15	$190.55	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $60.26 / $131.83	Professional	26	$32.36	$60.26	$131.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.62 / $72.44 / $245.47	Professional	52	$31.62	$72.44	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $109.65 / $199.53	Professional	TC	$79.43	$109.65	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $173.78	Professional		$79.43	$97.72	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.84 / $52.48	Professional	26	$26.92	$28.84	$52.48
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $23.44 / $23.99 / $58.88	Professional	52	$23.44	$23.99	$58.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $83.18 / $128.82	Professional	TC	$61.66	$83.18	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $229.09	Professional		$109.65	$141.25	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $39.81 / $64.57	Professional	26	$31.62	$39.81	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $102.33 / $165.96	Professional	TC	$77.62	$102.33	$165.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $102.33 / $158.49	Professional		$38.02	$102.33	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $269.15	Professional		$104.71	$165.96	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $75.86	Professional	26	$30.90	$45.71	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $117.49 / $194.98	Professional	TC	$79.43	$117.49	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $234.42	Professional		$117.49	$154.88	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $66.07	Professional	26	$33.11	$43.65	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $109.65 / $173.78	Professional	TC	$85.11	$109.65	$173.78