Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.15 / $50.41 / $101.48	Facility	26	$42.15	$50.41	$101.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.06 / $185.43 / $611.88	Professional		$85.06	$185.43	$611.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.16 / $66.15 / $226.81	Professional	26	$42.16	$66.15	$226.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.53 / $52.38 / $132.32	Professional	52	$42.53	$52.38	$132.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.89 / $96.46 / $197.97	Professional	TC	$42.89	$96.46	$197.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.40 / $128.19 / $128.19	Professional		$81.40	$128.19	$128.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.57 / $50.41 / $56.55	Professional	26	$37.57	$50.41	$56.55
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 $125.28 / $167.04 / $300.00	Professional		$125.28	$167.04	$300.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $67.08 / $92.57	Professional	26	$50.31	$67.08	$92.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.79 / $99.96 / $199.39	Professional	TC	$68.79	$99.96	$199.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $58.48 / $118.45	Professional		$44.36	$58.48	$118.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.09 / $240.09 / $372.90	Professional		$98.09	$240.09	$372.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $92.56 / $141.97	Professional	26	$45.68	$92.56	$141.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.40 / $142.52 / $217.47	Professional	TC	$53.40	$142.52	$217.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $98.19 / $192.37	Professional		$32.34	$98.19	$192.37
United Facility/Professional Professional Modifier Low / Median / High Price $107.20 / $194.83 / $283.19	Professional		$107.20	$194.83	$283.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.55 / $78.81 / $111.83	Professional	26	$44.55	$78.81	$111.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.88 / $114.58 / $160.00	Professional	TC	$63.88	$114.58	$160.00