Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $165.96 / $229.09	Facility	26	$128.82	$165.96	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $758.58 / $1,412.54	Professional		$588.84	$758.58	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $169.82 / $398.11	Professional	26	$117.49	$169.82	$398.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $199.53 / $257.04 / $1,258.93	Professional	52	$199.53	$257.04	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $549.54 / $1,047.13	Professional	TC	$467.74	$549.54	$1,047.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $645.65 / $977.24	Professional		$537.03	$645.65	$977.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $144.54 / $177.83	Professional	26	$107.15	$144.54	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $467.74 / $524.81	Professional	TC	$323.59	$467.74	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $1,000.00	Professional		$489.78	$616.60	$1,000.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $125.89 / $199.53	Professional	26	$104.71	$125.89	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $489.78 / $794.33	Professional	TC	$389.05	$489.78	$794.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $562.34 / $794.33	Professional		$123.03	$562.34	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $891.25 / $1,819.70	Professional		$630.96	$891.25	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $190.55 / $380.19	Professional	26	$128.82	$190.55	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $691.83 / $1,412.54	Professional	TC	$489.78	$691.83	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $758.58 / $1,318.26	Professional		$562.34	$758.58	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $154.88 / $269.15	Professional	26	$112.20	$154.88	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $602.56 / $1,071.52	Professional	TC	$457.09	$602.56	$1,071.52