Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.94 / $137.88 / $147.68	Facility	26	$110.94	$137.88	$147.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.03 / $496.33 / $661.50	Professional		$446.03	$496.33	$661.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.94 / $145.65 / $201.45	Professional	26	$110.94	$145.65	$201.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $248.17 / $317.51	Professional	52	$125.00	$248.17	$317.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $305.00 / $348.65 / $487.32	Professional	TC	$305.00	$348.65	$487.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $133.21 / $140.19 / $154.77	Professional	26	$133.21	$140.19	$154.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $275.18 / $275.18 / $275.18	Professional	TC	$275.18	$275.18	$275.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $300.77 / $398.09 / $442.32	Professional		$300.77	$398.09	$442.32
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.66 / $121.32 / $134.80	Professional	26	$91.66	$121.32	$134.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $209.11 / $276.77 / $307.52	Professional	TC	$209.11	$276.77	$307.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $283.62 / $588.42 / $918.63	Professional		$283.62	$588.42	$918.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.70 / $128.02 / $184.02	Professional	26	$81.70	$128.02	$184.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.40 / $396.70 / $750.00	Professional	TC	$198.40	$396.70	$750.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $153.19 / $159.38 / $177.99	Professional	26	$153.19	$159.38	$177.99
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $316.45 / $316.45 / $316.45	Professional	TC	$316.45	$316.45	$316.45
United Facility/Professional Professional Modifier Low / Median / High Price $292.95 / $521.01 / $713.51	Professional		$292.95	$521.01	$713.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.37 / $130.88 / $171.92	Professional	26	$81.37	$130.88	$171.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.52 / $347.43 / $658.42	Professional	TC	$204.52	$347.43	$658.42