Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.94 / $84.50 / $104.45	Facility	26	$55.94	$84.50	$104.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $225.72 / $382.75	Professional		$171.00	$225.72	$382.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $78.87 / $184.50	Professional	26	$46.89	$78.87	$184.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $85.50 / $111.16 / $162.50	Professional	52	$85.50	$111.16	$162.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.54 / $177.61 / $291.63	Professional	TC	$97.54	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.24 / $210.40 / $229.76	Professional		$204.24	$210.40	$229.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $80.65 / $93.71	Professional	26	$38.15	$80.65	$93.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $121.57 / $151.00 / $197.37	Professional	TC	$121.57	$151.00	$197.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.80 / $202.23 / $224.70	Professional		$152.80	$202.23	$224.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.83 / $79.19 / $87.99	Professional	26	$59.83	$79.19	$87.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.96 / $123.04 / $136.71	Professional	TC	$92.96	$123.04	$136.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.88 / $82.55 / $153.33	Professional		$49.88	$82.55	$153.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.35 / $270.04 / $447.58	Professional		$154.35	$270.04	$447.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.45 / $75.79 / $116.76	Professional	26	$46.45	$75.79	$116.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.93 / $180.94 / $328.20	Professional	TC	$94.93	$180.94	$328.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $234.88 / $241.96 / $264.22	Professional		$234.88	$241.96	$264.22
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $45.84 / $92.75 / $107.77	Professional	26	$45.84	$92.75	$107.77
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $145.46 / $173.65 / $226.98	Professional	TC	$145.46	$173.65	$226.98
United Facility/Professional Professional Modifier Low / Median / High Price $141.05 / $245.72 / $357.33	Professional		$141.05	$245.72	$357.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $65.11 / $105.88	Professional	26	$51.28	$65.11	$105.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.27 / $152.25 / $278.76	Professional	TC	$89.27	$152.25	$278.76