Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.54 / $176.61 / $190.12	Facility	26	$146.54	$176.61	$190.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.06 / $541.72 / $882.39	Professional		$418.06	$541.72	$882.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.55 / $176.40 / $363.80	Professional	26	$99.55	$176.40	$363.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $145.41 / $293.39 / $401.09	Professional	52	$145.41	$293.39	$401.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.38 / $368.50 / $462.42	Professional	TC	$249.38	$368.50	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $475.23 / $501.68 / $547.84	Professional		$475.23	$501.68	$547.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.14 / $178.31 / $199.12	Professional	26	$81.14	$178.31	$199.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $310.80 / $323.37 / $520.99	Professional	TC	$310.80	$323.37	$520.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $355.59 / $470.63 / $522.91	Professional		$355.59	$470.63	$522.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.32 / $155.28 / $172.53	Professional	26	$117.32	$155.28	$172.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.27 / $315.35 / $350.39	Professional	TC	$238.27	$315.35	$350.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.99 / $211.12 / $366.38	Professional		$105.99	$211.12	$366.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.50 / $698.64 / $1,581.88	Professional		$335.50	$698.64	$1,581.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.87 / $169.07 / $236.57	Professional	26	$104.87	$169.07	$236.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.05 / $459.85 / $1,381.81	Professional	TC	$226.05	$459.85	$1,381.81
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $560.04 / $576.92 / $630.02	Professional		$560.04	$576.92	$630.02
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $186.75 / $206.10 / $247.25	Professional	26	$186.75	$206.10	$247.25
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $357.42 / $371.88 / $599.14	Professional	TC	$357.42	$371.88	$599.14
United Facility/Professional Professional Modifier Low / Median / High Price $344.87 / $609.55 / $1,257.05	Professional		$344.87	$609.55	$1,257.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.65 / $164.21 / $214.43	Professional	26	$107.65	$164.21	$214.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.08 / $395.99 / $959.14	Professional	TC	$233.08	$395.99	$959.14