Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.44 / $148.04 / $245.00	Facility	26	$118.44	$148.04	$245.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $548.21 / $644.78 / $968.94	Professional		$548.21	$644.78	$968.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.17 / $123.37 / $215.46	Professional	26	$110.17	$123.37	$215.46
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $264.81 / $307.55 / $366.80	Professional	52	$264.81	$307.55	$366.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $434.27 / $518.21 / $673.67	Professional	TC	$434.27	$518.21	$673.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $571.29 / $845.84 / $845.84	Professional		$571.29	$845.84	$845.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $106.50 / $135.83 / $173.86	Professional	26	$106.50	$135.83	$173.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $469.52 / $586.26 / $908.70	Professional		$469.52	$586.26	$908.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.31 / $119.97 / $170.35	Professional	26	$101.31	$119.97	$170.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $368.21 / $466.29 / $722.74	Professional	TC	$368.21	$466.29	$722.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.09 / $523.51 / $718.33	Professional		$114.09	$523.51	$718.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $620.74 / $873.76 / $1,557.03	Professional		$620.74	$873.76	$1,557.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.89 / $190.03 / $351.02	Professional	26	$127.89	$190.03	$351.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $493.54 / $669.07 / $1,226.01	Professional	TC	$493.54	$669.07	$1,226.01
United Facility/Professional Professional Modifier Low / Median / High Price $551.50 / $718.68 / $1,400.41	Professional		$551.50	$718.68	$1,400.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.14 / $141.41 / $247.25	Professional	26	$102.14	$141.41	$247.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $428.55 / $548.19 / $966.26	Professional	TC	$428.55	$548.19	$966.26