Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $107.15 / $123.03	Facility	26	$89.13	$107.15	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $281.84 / $446.68	Professional		$194.98	$281.84	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $79.43 / $186.21	Professional	26	$57.54	$79.43	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $190.55 / $323.59	Professional	TC	$131.83	$190.55	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $338.84 / $407.38	Professional		$169.82	$338.84	$407.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $125.89 / $141.25	Professional	26	$57.54	$125.89	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $323.59 / $323.59	Professional	TC	$323.59	$323.59	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $346.74	Professional		$234.42	$269.15	$346.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $95.50 / $123.03	Professional	26	$83.18	$95.50	$123.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $173.78 / $223.87	Professional	TC	$151.36	$173.78	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $575.44	Professional		$213.80	$398.11	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $102.33 / $165.96	Professional	26	$66.07	$102.33	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $275.42 / $426.58	Professional	TC	$147.91	$275.42	$426.58
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $147.91 / $186.21	Professional	26	$128.82	$147.91	$186.21
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	TC	$371.54	$371.54	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $524.81	Professional		$218.78	$354.81	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $85.11 / $151.36	Professional	26	$70.79	$85.11	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $229.09 / $416.87	Professional	TC	$144.54	$229.09	$416.87