Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $123.03 / $138.04	Facility	26	$77.62	$123.03	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $426.58 / $794.33	Professional		$288.40	$426.58	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $199.53	Professional	26	$67.61	$114.82	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $616.60	Professional	TC	$229.09	$338.84	$616.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $112.20 / $128.82	Professional	26	$52.48	$112.20	$128.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	TC	$398.11	$398.11	$398.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $575.44	Professional		$389.05	$446.68	$575.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $112.20	Professional	26	$75.86	$87.10	$112.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $354.81 / $457.09	Professional	TC	$309.03	$354.81	$457.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $234.42 / $407.38	Professional		$67.61	$234.42	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $776.25 / $1,380.38	Professional		$363.08	$776.25	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $114.82 / $162.18	Professional	26	$72.44	$114.82	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $575.44 / $1,230.27	Professional	TC	$295.12	$575.44	$1,230.27
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $141.25 / $169.82	Professional	26	$128.82	$141.25	$169.82
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $457.09 / $457.09	Professional	TC	$457.09	$457.09	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $1,230.27	Professional		$331.13	$588.84	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $91.20 / $154.88	Professional	26	$66.07	$91.20	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $457.09 / $1,071.52	Professional	TC	$263.03	$457.09	$1,071.52