Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.43 / $161.79 / $176.90	Facility	26	$127.43	$161.79	$176.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $437.36 / $567.52 / $756.74	Professional		$437.36	$567.52	$756.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.00 / $168.47 / $386.40	Professional	26	$110.00	$168.47	$386.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $296.76 / $404.42 / $462.42	Professional	TC	$296.76	$404.42	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $515.24 / $515.24 / $568.88	Professional		$515.24	$515.24	$568.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.68 / $160.85 / $186.88	Professional	26	$83.68	$160.85	$186.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $378.86 / $501.44 / $557.15	Professional		$378.86	$501.44	$557.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.79 / $145.31 / $161.46	Professional	26	$109.79	$145.31	$161.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.07 / $356.12 / $395.69	Professional	TC	$269.07	$356.12	$395.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.49 / $237.21 / $388.48	Professional		$99.49	$237.21	$388.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.72 / $703.13 / $1,506.13	Professional		$371.72	$703.13	$1,506.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.00 / $145.59 / $218.68	Professional	26	$98.00	$145.59	$218.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.76 / $523.11 / $1,368.55	Professional	TC	$274.76	$523.11	$1,368.55
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $592.53 / $592.53 / $654.21	Professional		$592.53	$592.53	$654.21
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $96.23 / $184.98 / $214.91	Professional	26	$96.23	$184.98	$214.91
United Facility/Professional Professional Modifier Low / Median / High Price $375.76 / $672.42 / $1,234.97	Professional		$375.76	$672.42	$1,234.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.65 / $124.74 / $200.69	Professional	26	$97.65	$124.74	$200.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.99 / $429.78 / $943.63	Professional	TC	$248.99	$429.78	$943.63