Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.03 / $52.23 / $93.89	Facility	26	$44.03	$52.23	$93.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $104.76 / $198.00	Professional		$87.32	$104.76	$198.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.76 / $52.13 / $101.48	Professional	26	$41.76	$52.13	$101.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.71 / $48.51 / $80.92	Professional	52	$42.71	$48.51	$80.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.29 / $55.20 / $131.86	Professional	TC	$44.29	$55.20	$131.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $81.40 / $164.00	Professional		$79.48	$81.40	$164.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.57 / $50.49 / $62.60	Professional	26	$37.57	$50.49	$62.60
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $20.35 / $20.35 / $20.35	Professional	52	$20.35	$20.35	$20.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.12 / $175.15 / $280.24	Professional		$140.12	$175.15	$280.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $61.38 / $83.43	Professional	26	$52.17	$61.38	$83.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.96 / $113.77 / $185.44	Professional	TC	$84.96	$113.77	$185.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.41 / $56.87 / $109.41	Professional		$42.41	$56.87	$109.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.09 / $233.59 / $502.03	Professional		$98.09	$233.59	$502.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.24 / $85.98 / $157.35	Professional	26	$46.24	$85.98	$157.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.40 / $131.25 / $282.20	Professional	TC	$53.40	$131.25	$282.20
United Facility/Professional Professional Modifier Low / Median / High Price $101.24 / $171.16 / $308.58	Professional		$101.24	$171.16	$308.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.57 / $65.05 / $111.99	Professional	26	$41.57	$65.05	$111.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $101.73 / $193.52	Professional	TC	$60.51	$101.73	$193.52