Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.45 / $100.34 / $111.33	Facility	26	$71.45	$100.34	$111.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.18 / $312.27 / $508.47	Professional		$208.18	$312.27	$508.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.55 / $90.84 / $153.29	Professional	26	$59.55	$90.84	$153.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.03 / $221.81 / $364.25	Professional	TC	$141.03	$221.81	$364.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.58 / $281.58 / $316.75	Professional		$281.58	$281.58	$316.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.60 / $107.19 / $119.70	Professional	26	$53.60	$107.19	$119.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $175.76 / $175.76 / $263.98	Professional	TC	$175.76	$175.76	$263.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.83 / $257.87 / $286.52	Professional		$194.83	$257.87	$286.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.06 / $94.05 / $104.50	Professional	26	$71.06	$94.05	$104.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.77 / $163.82 / $182.02	Professional	TC	$123.77	$163.82	$182.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.72 / $119.43 / $211.70	Professional		$63.72	$119.43	$211.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.29 / $327.67 / $468.76	Professional		$188.29	$327.67	$468.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.17 / $95.47 / $142.82	Professional	26	$63.17	$95.47	$142.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.39 / $221.93 / $330.95	Professional	TC	$126.39	$221.93	$330.95
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $323.82 / $323.82 / $364.26	Professional		$323.82	$323.82	$364.26
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $117.23 / $124.56 / $137.66	Professional	26	$117.23	$124.56	$137.66
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $202.12 / $202.12 / $303.58	Professional	TC	$202.12	$202.12	$303.58
United Facility/Professional Professional Modifier Low / Median / High Price $185.14 / $303.70 / $386.36	Professional		$185.14	$303.70	$386.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.03 / $84.89 / $130.50	Professional	26	$63.03	$84.89	$130.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.47 / $206.31 / $277.43	Professional	TC	$121.47	$206.31	$277.43