Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.14 / $61.64 / $77.27	Facility	26	$44.14	$61.64	$77.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.24 / $180.79 / $325.00	Professional		$130.24	$180.79	$325.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.50 / $61.64 / $171.70	Professional	26	$36.50	$61.64	$171.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.64 / $137.25 / $240.00	Professional	TC	$83.64	$137.25	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.72 / $168.66 / $180.77	Professional		$163.72	$168.66	$180.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.63 / $64.92 / $73.94	Professional	26	$30.63	$64.92	$73.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.46 / $112.15 / $112.15	Professional	TC	$102.46	$112.15	$112.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.44 / $147.49 / $163.88	Professional		$111.44	$147.49	$163.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $57.77 / $64.19	Professional	26	$43.65	$57.77	$64.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.79 / $89.72 / $99.69	Professional	TC	$67.79	$89.72	$99.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $66.90 / $122.95	Professional		$39.36	$66.90	$122.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.10 / $206.91 / $350.65	Professional		$106.10	$206.91	$350.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $58.45 / $87.81	Professional	26	$38.72	$58.45	$87.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.36 / $121.34 / $262.19	Professional	TC	$67.36	$121.34	$262.19
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $188.28 / $205.47 / $207.89	Professional		$188.28	$205.47	$207.89
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.16 / $76.50 / $85.03	Professional	26	$69.16	$76.50	$85.03
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $117.83 / $117.83 / $128.97	Professional	TC	$117.83	$117.83	$128.97
United Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $190.97 / $265.81	Professional		$107.62	$190.97	$265.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $49.48 / $79.55	Professional	26	$37.99	$49.48	$79.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.84 / $109.33 / $195.77	Professional	TC	$64.84	$109.33	$195.77