Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.21 / $119.47 / $134.49	Facility	26	$88.21	$119.47	$134.49
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $47.25 / $71.87 / $115.00	Facility	53	$47.25	$71.87	$115.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.08 / $475.00 / $701.98	Professional		$258.08	$475.00	$701.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $123.10 / $327.58	Professional	26	$67.09	$123.10	$327.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $179.67 / $275.00	Professional	52	$125.00	$179.67	$275.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $244.98 / $441.00	Professional	TC	$187.50	$244.98	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.26 / $309.70 / $331.93	Professional		$289.26	$309.70	$331.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.04 / $112.56 / $128.22	Professional	26	$60.04	$112.56	$128.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $194.89 / $194.94 / $309.38	Professional	TC	$194.89	$194.94	$309.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.51 / $287.88 / $319.87	Professional		$217.51	$287.88	$319.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.18 / $100.83 / $112.03	Professional	26	$76.18	$100.83	$112.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.33 / $187.06 / $207.84	Professional	TC	$141.33	$187.06	$207.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.26 / $127.26 / $226.01	Professional		$68.26	$127.26	$226.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.37 / $428.12 / $769.51	Professional		$206.37	$428.12	$769.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.62 / $105.93 / $154.72	Professional	26	$67.62	$105.93	$154.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.08 / $274.83 / $622.04	Professional	TC	$134.08	$274.83	$622.04
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $345.74 / $356.17 / $388.93	Professional		$345.74	$356.17	$388.93
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $124.96 / $132.77 / $159.85	Professional	26	$124.96	$132.77	$159.85
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $224.12 / $264.50 / $355.79	Professional	TC	$224.12	$264.50	$355.79
United Facility/Professional Professional Modifier Low / Median / High Price $208.51 / $379.14 / $598.04	Professional		$208.51	$379.14	$598.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.47 / $91.38 / $143.22	Professional	26	$67.47	$91.38	$143.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.80 / $229.84 / $493.23	Professional	TC	$137.80	$229.84	$493.23