Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.52 / $93.27 / $103.48	Facility	26	$79.52	$93.27	$103.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $253.60 / $368.92	Professional		$171.00	$253.60	$368.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $80.09 / $105.21	Professional	26	$55.15	$80.09	$105.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.52 / $177.61 / $291.63	Professional	TC	$115.52	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.45 / $115.45 / $115.45	Professional		$115.45	$115.45	$115.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $95.99 / $107.04	Professional	26	$44.68	$95.99	$107.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.68 / $210.02 / $233.35	Professional		$158.68	$210.02	$233.35
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 $92.96 / $123.04 / $136.71	Professional	TC	$92.96	$123.04	$136.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.36 / $93.24 / $173.16	Professional		$59.36	$93.24	$173.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.94 / $272.89 / $388.52	Professional		$157.94	$272.89	$388.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.58 / $88.60 / $129.94	Professional	26	$58.58	$88.60	$129.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.93 / $185.07 / $274.39	Professional	TC	$94.93	$185.07	$274.39
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $132.77 / $132.77 / $132.77	Professional		$132.77	$132.77	$132.77
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $76.72 / $114.84 / $128.25	Professional	26	$76.72	$114.84	$128.25
United Facility/Professional Professional Modifier Low / Median / High Price $150.38 / $252.40 / $325.64	Professional		$150.38	$252.40	$325.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.45 / $78.81 / $120.33	Professional	26	$58.45	$78.81	$120.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.28 / $154.94 / $231.35	Professional	TC	$89.28	$154.94	$231.35