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 $277.85 / $396.93 / $615.49	Professional		$277.85	$396.93	$615.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.41 / $108.93 / $187.85	Professional	26	$73.41	$108.93	$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 $199.56 / $199.56 / $199.56	Professional		$199.56	$199.56	$199.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.79 / $130.57 / $151.69	Professional	26	$62.79	$130.57	$151.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.74 / $372.90 / $414.33	Professional		$281.74	$372.90	$414.33
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 $191.88 / $253.96 / $282.18	Professional	TC	$191.88	$253.96	$282.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $194.14 / $317.10	Professional		$80.75	$194.14	$317.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.70 / $486.08 / $758.31	Professional		$287.70	$486.08	$758.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.80 / $120.79 / $177.86	Professional	26	$79.80	$120.79	$177.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.25 / $377.36 / $619.91	Professional	TC	$196.25	$377.36	$619.91
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $229.49 / $229.49 / $229.49	Professional		$229.49	$229.49	$229.49
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $74.08 / $150.16 / $174.46	Professional	26	$74.08	$150.16	$174.46
United Facility/Professional Professional Modifier Low / Median / High Price $266.11 / $461.67 / $596.77	Professional		$266.11	$461.67	$596.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.31 / $101.63 / $163.90	Professional	26	$79.31	$101.63	$163.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.49 / $336.69 / $502.65	Professional	TC	$190.49	$336.69	$502.65