Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.81 / $81.64 / $100.30	Facility	26	$80.81	$81.64	$100.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.12 / $287.22 / $458.16	Professional		$172.12	$287.22	$458.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.06 / $81.64 / $161.81	Professional	26	$56.06	$81.64	$161.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $227.00 / $379.60	Professional	TC	$119.70	$227.00	$379.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $261.70 / $261.70 / $261.70	Professional		$261.70	$261.70	$261.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.60 / $86.10 / $94.13	Professional	26	$41.60	$86.10	$94.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $170.98 / $170.98 / $170.98	Professional	TC	$170.98	$170.98	$170.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.71 / $212.71 / $236.34	Professional		$160.71	$212.71	$236.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.81 / $76.52 / $85.02	Professional	26	$57.81	$76.52	$85.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.90 / $136.19 / $151.32	Professional	TC	$102.90	$136.19	$151.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.21 / $99.20 / $174.93	Professional		$52.21	$99.20	$174.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.12 / $313.48 / $435.54	Professional		$164.12	$313.48	$435.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.85 / $84.48 / $116.60	Professional	26	$54.85	$84.48	$116.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.08 / $202.00 / $328.93	Professional	TC	$105.08	$202.00	$328.93
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $67.86 / $100.99 / $112.79	Professional	26	$67.86	$100.99	$112.79
United Facility/Professional Professional Modifier Low / Median / High Price $157.75 / $284.30 / $347.37	Professional		$157.75	$284.30	$347.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $71.17 / $106.20	Professional	26	$53.70	$71.17	$106.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.78 / $174.78 / $277.42	Professional	TC	$100.78	$174.78	$277.42