Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.52 / $92.80 / $103.48	Facility	26	$79.52	$92.80	$103.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.33 / $259.57 / $368.92	Professional		$179.33	$259.57	$368.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.48 / $86.24 / $176.00	Professional	26	$55.48	$86.24	$176.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $177.61 / $291.63	Professional	TC	$119.70	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $274.30 / $274.30 / $274.30	Professional		$274.30	$274.30	$274.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.99 / $99.86 / $101.06	Professional	26	$95.99	$99.86	$101.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $211.56 / $211.56 / $211.56	Professional	TC	$211.56	$211.56	$211.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.28 / $294.19 / $326.88	Professional		$222.28	$294.19	$326.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.72 / $86.98 / $96.64	Professional	26	$65.72	$86.98	$96.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $156.56 / $207.22 / $230.24	Professional	TC	$156.56	$207.22	$230.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.36 / $98.88 / $183.05	Professional		$59.36	$98.88	$183.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.91 / $331.52 / $433.21	Professional		$206.91	$331.52	$433.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.58 / $88.60 / $131.83	Professional	26	$58.58	$88.60	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.57 / $224.53 / $311.58	Professional	TC	$139.57	$224.53	$311.58
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $108.31 / $115.07 / $128.25	Professional	26	$108.31	$115.07	$128.25
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $243.29 / $243.29 / $243.29	Professional	TC	$243.29	$243.29	$243.29
United Facility/Professional Professional Modifier Low / Median / High Price $186.10 / $292.42 / $390.76	Professional		$186.10	$292.42	$390.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.45 / $80.45 / $120.33	Professional	26	$58.45	$80.45	$120.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.26 / $202.29 / $270.20	Professional	TC	$120.26	$202.29	$270.20