Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.38 / $90.19 / $121.75	Facility	26	$60.38	$90.19	$121.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.34 / $300.00 / $521.70	Professional		$189.34	$300.00	$521.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $85.23 / $223.73	Professional	26	$51.30	$85.23	$223.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.53 / $228.97 / $376.02	Professional	TC	$132.53	$228.97	$376.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.37 / $131.21 / $286.57	Professional		$127.37	$131.21	$286.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.18 / $88.80 / $101.15	Professional	26	$41.18	$88.80	$101.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.92 / $206.00 / $208.86	Professional	TC	$85.92	$206.00	$208.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.30 / $249.22 / $276.91	Professional		$188.30	$249.22	$276.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.87 / $84.54 / $93.93	Professional	26	$63.87	$84.54	$93.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.43 / $164.68 / $182.98	Professional	TC	$124.43	$164.68	$182.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.84 / $112.25 / $191.80	Professional		$53.84	$112.25	$191.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.65 / $333.50 / $522.29	Professional		$178.65	$333.50	$522.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.93 / $85.68 / $128.76	Professional	26	$56.93	$85.68	$128.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.06 / $239.26 / $400.00	Professional	TC	$127.06	$239.26	$400.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $146.47 / $301.77 / $329.56	Professional		$146.47	$301.77	$329.56
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $52.08 / $106.31 / $116.32	Professional	26	$52.08	$106.31	$116.32
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $197.63 / $201.34 / $240.19	Professional	TC	$197.63	$201.34	$240.19
United Facility/Professional Professional Modifier Low / Median / High Price $179.29 / $304.64 / $439.08	Professional		$179.29	$304.64	$439.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.61 / $72.54 / $114.03	Professional	26	$56.61	$72.54	$114.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.10 / $203.23 / $312.55	Professional	TC	$119.10	$203.23	$312.55