Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.84 / $92.27 / $102.80	Facility	26	$65.84	$92.27	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.37 / $294.55 / $488.76	Professional		$196.37	$294.55	$488.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $83.73 / $141.71	Professional	26	$54.86	$83.73	$141.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.46 / $219.15 / $394.05	Professional	TC	$134.46	$219.15	$394.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $265.14 / $273.14 / $273.14	Professional		$265.14	$273.14	$273.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.34 / $99.51 / $110.31	Professional	26	$66.34	$99.51	$110.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $167.57 / $167.57 / $252.11	Professional	TC	$167.57	$167.57	$252.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.80 / $243.27 / $270.30	Professional		$183.80	$243.27	$270.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.33 / $86.47 / $96.08	Professional	26	$65.33	$86.47	$96.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.47 / $156.80 / $174.22	Professional	TC	$118.47	$156.80	$174.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.72 / $113.88 / $199.43	Professional		$58.72	$113.88	$199.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.64 / $325.20 / $525.20	Professional		$173.64	$325.20	$525.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $87.65 / $131.06	Professional	26	$58.24	$87.65	$131.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.11 / $188.29 / $392.60	Professional	TC	$115.11	$188.29	$392.60
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $304.92 / $314.12 / $314.12	Professional		$304.92	$314.12	$314.12
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $76.29 / $114.44 / $126.86	Professional	26	$76.29	$114.44	$126.86
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $192.71 / $192.71 / $192.71	Professional	TC	$192.71	$192.71	$192.71
United Facility/Professional Professional Modifier Low / Median / High Price $172.39 / $301.68 / $397.91	Professional		$172.39	$301.68	$397.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.82 / $73.84 / $116.93	Professional	26	$57.82	$73.84	$116.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.86 / $194.00 / $299.39	Professional	TC	$110.86	$194.00	$299.39