Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $91.20 / $100.00	Facility	26	$81.28	$91.20	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $562.34	Professional		$218.78	$354.81	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $109.65 / $169.82	Professional	26	$57.54	$109.65	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $257.04 / $436.52	Professional	TC	$162.18	$257.04	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $380.19 / $398.11	Professional		$190.55	$380.19	$398.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $102.33	Professional	26	$42.66	$60.26	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $302.00 / $389.05	Professional		$263.03	$302.00	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $91.20	Professional	26	$61.66	$70.79	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $234.42 / $295.12	Professional	TC	$204.17	$234.42	$295.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $173.78 / $323.59	Professional		$54.95	$173.78	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $489.78 / $758.58	Professional		$251.19	$489.78	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $134.90	Professional	26	$54.95	$83.18	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $380.19 / $676.08	Professional	TC	$190.55	$380.19	$676.08
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $107.15 / $120.23	Professional	26	$36.31	$107.15	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $389.05 / $741.31	Professional		$218.78	$389.05	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $112.20	Professional	26	$52.48	$66.07	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $281.84 / $645.65	Professional	TC	$162.18	$281.84	$645.65