Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $95.50 / $109.65	Facility	26	$87.10	$95.50	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $416.87	Professional		$169.82	$239.88	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $128.82	Professional	26	$51.29	$64.57	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $158.49 / $338.84	Professional	TC	$120.23	$158.49	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $66.07 / $102.33	Professional	26	$44.67	$66.07	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Professional	TC	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $223.87 / $288.40	Professional		$194.98	$223.87	$288.40
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 $128.82 / $147.91 / $190.55	Professional	TC	$128.82	$147.91	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $588.84	Professional		$186.21	$380.19	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $138.04	Professional	26	$61.66	$91.20	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $263.03 / $416.87	Professional	TC	$123.03	$263.03	$416.87
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $109.65 / $117.49	Professional	26	$75.86	$109.65	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $524.81	Professional		$181.97	$302.00	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $125.89	Professional	26	$56.23	$70.79	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $199.53 / $416.87	Professional	TC	$123.03	$199.53	$416.87