Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $93.33 / $97.72	Facility	26	$66.07	$93.33	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $416.87	Professional		$169.82	$229.09	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $144.54	Professional	26	$53.70	$77.62	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $144.54 / $269.15	Professional	TC	$114.82	$144.54	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $338.84	Professional		$131.83	$138.04	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $95.50 / $109.65	Professional	26	$44.67	$95.50	$109.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $107.15 / $194.98	Professional	TC	$83.18	$107.15	$194.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $208.93 / $269.15	Professional		$181.97	$208.93	$269.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $74.13 / $95.50	Professional	26	$66.07	$74.13	$95.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $134.90 / $173.78	Professional	TC	$117.49	$134.90	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $134.90 / $257.04	Professional		$58.88	$134.90	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $338.84 / $524.81	Professional		$173.78	$338.84	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $87.10 / $141.25	Professional	26	$58.88	$87.10	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $239.88 / $389.05	Professional	TC	$112.20	$239.88	$389.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $158.49	Professional		$154.88	$154.88	$158.49
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $112.20 / $128.82	Professional	26	$57.54	$112.20	$128.82
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	TC	$95.50	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $489.78	Professional		$169.82	$281.84	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $117.49	Professional	26	$56.23	$70.79	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $177.83 / $354.81	Professional	TC	$109.65	$177.83	$354.81