Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.70 / $35.25 / $63.79	Facility	26	$31.70	$35.25	$63.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.59 / $143.12 / $553.86	Professional		$115.59	$143.12	$553.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $41.38 / $141.69	Professional	26	$32.71	$41.38	$141.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.02 / $225.68 / $762.00	Professional	52	$40.02	$225.68	$762.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.88 / $98.52 / $174.18	Professional	TC	$80.88	$98.52	$174.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.67 / $124.93 / $168.45	Professional		$92.67	$124.93	$168.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $37.08 / $43.82	Professional	26	$26.85	$37.08	$43.82
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $83.57 / $83.57 / $83.57	Professional	52	$83.57	$83.57	$83.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.31 / $81.02 / $87.75	Professional	TC	$66.31	$81.02	$87.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.47 / $109.02 / $157.19	Professional		$106.47	$109.02	$157.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $31.98 / $44.24	Professional	26	$29.51	$31.98	$44.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.04 / $77.04 / $108.86	Professional	TC	$77.04	$77.04	$108.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.59 / $90.38 / $157.22	Professional		$38.59	$90.38	$157.22
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 / $170.80 / $284.98	Professional		$115.27	$170.80	$284.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.82 / $50.19 / $83.36	Professional	26	$35.82	$50.19	$83.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.76 / $122.80 / $201.62	Professional	TC	$89.76	$122.80	$201.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $107.46	Professional		$32.34	$32.34	$107.46
United Facility/Professional Professional Modifier Low / Median / High Price $121.58 / $153.12 / $195.03	Professional		$121.58	$153.12	$195.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $43.07 / $56.63	Professional	26	$35.79	$43.07	$56.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.77 / $108.29 / $139.94	Professional	TC	$86.77	$108.29	$139.94