Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.56 / $126.89 / $141.22	Facility	26	$90.56	$126.89	$141.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.42 / $431.44 / $615.49	Professional		$297.42	$431.44	$615.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.65 / $109.02 / $187.85	Professional	26	$75.65	$109.02	$187.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $212.31 / $310.24 / $509.48	Professional	TC	$212.31	$310.24	$509.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $240.13 / $399.12 / $399.12	Professional		$240.13	$399.12	$399.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.92 / $133.18 / $151.69	Professional	26	$67.92	$133.18	$151.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.41 / $373.78 / $415.31	Professional		$282.41	$373.78	$415.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.86 / $118.94 / $132.15	Professional	26	$89.86	$118.94	$132.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $192.55 / $254.84 / $283.16	Professional	TC	$192.55	$254.84	$283.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $194.48 / $317.45	Professional		$80.75	$194.48	$317.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.39 / $483.75 / $752.30	Professional		$288.39	$483.75	$752.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.09 / $120.79 / $177.86	Professional	26	$80.09	$120.79	$177.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.63 / $378.00 / $618.08	Professional	TC	$196.63	$378.00	$618.08
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $458.99 / $458.99 / $458.99	Professional		$458.99	$458.99	$458.99
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.11 / $158.06 / $194.35	Professional	26	$78.11	$158.06	$194.35
United Facility/Professional Professional Modifier Low / Median / High Price $277.24 / $446.17 / $602.70	Professional		$277.24	$446.17	$602.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.61 / $101.63 / $163.90	Professional	26	$79.61	$101.63	$163.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.30 / $340.71 / $510.82	Professional	TC	$184.30	$340.71	$510.82