Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.68 / $141.21 / $253.91	Facility	26	$117.68	$141.21	$253.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $572.95 / $821.91 / $1,828.61	Professional		$572.95	$821.91	$1,828.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.68 / $138.75 / $548.62	Professional	26	$117.68	$138.75	$548.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $286.48 / $331.88 / $467.76	Professional	52	$286.48	$331.88	$467.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $455.27 / $654.21 / $1,026.48	Professional	TC	$455.27	$654.21	$1,026.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $569.49 / $569.49 / $740.34	Professional		$569.49	$569.49	$740.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $105.19 / $147.10 / $158.41	Professional	26	$105.19	$147.10	$158.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $456.34 / $456.34 / $456.34	Professional	TC	$456.34	$456.34	$456.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $492.45 / $616.00 / $916.10	Professional		$492.45	$616.00	$916.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.39 / $124.76 / $192.11	Professional	26	$105.39	$124.76	$192.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $387.06 / $491.24 / $732.06	Professional	TC	$387.06	$491.24	$732.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.47 / $524.79 / $797.29	Professional		$124.47	$524.79	$797.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.61 / $938.34 / $1,491.96	Professional		$630.61	$938.34	$1,491.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.27 / $207.79 / $337.10	Professional	26	$129.27	$207.79	$337.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $500.00 / $737.79 / $1,145.66	Professional	TC	$500.00	$737.79	$1,145.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $139.66 / $621.74	Professional		$32.34	$139.66	$621.74
United Facility/Professional Professional Modifier Low / Median / High Price $584.00 / $859.20 / $1,214.08	Professional		$584.00	$859.20	$1,214.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.58 / $177.60 / $271.24	Professional	26	$124.58	$177.60	$271.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $455.90 / $672.08 / $957.71	Professional	TC	$455.90	$672.08	$957.71