Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $158.49 / $177.83	Facility	26	$112.20	$158.49	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $478.63 / $1,000.00	Professional		$295.12	$478.63	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $158.49 / $323.59	Professional	26	$85.11	$158.49	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $338.84 / $602.56	Professional	TC	$213.80	$338.84	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $524.81 / $660.69	Professional		$263.03	$524.81	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $169.82	Professional	26	$75.86	$95.50	$169.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $346.74 / $346.74	Professional	TC	$346.74	$346.74	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $562.34	Professional		$380.19	$436.52	$562.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $125.89 / $162.18	Professional	26	$109.65	$125.89	$162.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $398.11	Professional	TC	$269.15	$309.03	$398.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $257.04 / $501.19	Professional		$100.00	$257.04	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $741.31 / $1,548.82	Professional		$363.08	$741.31	$1,548.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $144.54 / $229.09	Professional	26	$97.72	$144.54	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $524.81 / $1,380.38	Professional	TC	$257.04	$524.81	$1,380.38
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $660.69	Professional		$602.56	$602.56	$660.69
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $181.97 / $213.80	Professional	26	$64.57	$181.97	$213.80
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	TC	$398.11	$398.11	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $588.84 / $1,380.38	Professional		$346.74	$588.84	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $120.23 / $199.53	Professional	26	$95.50	$120.23	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $407.38 / $977.24	Professional	TC	$251.19	$407.38	$977.24