Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.06 / $82.42 / $91.48	Facility	26	$70.06	$82.42	$91.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.87 / $232.72 / $415.19	Professional		$167.87	$232.72	$415.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $74.54 / $98.00	Professional	26	$51.30	$74.54	$98.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.43 / $184.15 / $327.97	Professional	TC	$119.43	$184.15	$327.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.64 / $113.64 / $113.64	Professional		$113.64	$113.64	$113.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.42 / $87.82 / $98.08	Professional	26	$58.42	$87.82	$98.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $140.62 / $140.62 / $140.62	Professional	TC	$140.62	$140.62	$140.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.29 / $208.18 / $231.31	Professional		$157.29	$208.18	$231.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.37 / $77.26 / $85.84	Professional	26	$58.37	$77.26	$85.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.92 / $130.91 / $145.47	Professional	TC	$98.92	$130.91	$145.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.97 / $278.33 / $430.50	Professional		$144.97	$278.33	$430.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.67 / $77.83 / $116.60	Professional	26	$51.67	$77.83	$116.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.30 / $157.63 / $315.00	Professional	TC	$93.30	$157.63	$315.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Professional		$130.69	$130.69	$130.69
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $67.86 / $100.99 / $112.79	Professional	26	$67.86	$100.99	$112.79
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $161.71 / $161.71 / $161.71	Professional	TC	$161.71	$161.71	$161.71
United Facility/Professional Professional Modifier Low / Median / High Price $151.35 / $251.35 / $360.54	Professional		$151.35	$251.35	$360.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $71.16 / $105.86	Professional	26	$51.28	$71.16	$105.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.88 / $167.65 / $277.41	Professional	TC	$93.88	$167.65	$277.41