Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.57 / $100.35 / $111.33	Facility	26	$85.57	$100.35	$111.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.12 / $334.68 / $465.46	Professional		$223.12	$334.68	$465.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $78.30 / $103.11	Professional	26	$59.34	$78.30	$103.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.27 / $243.40 / $388.80	Professional	TC	$162.27	$243.40	$388.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.18 / $93.34 / $107.76	Professional	26	$46.18	$93.34	$107.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $202.22 / $257.83 / $257.83	Professional	TC	$202.22	$257.83	$257.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.99 / $295.13 / $327.92	Professional		$222.99	$295.13	$327.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.06 / $94.05 / $104.50	Professional	26	$71.06	$94.05	$104.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.93 / $201.08 / $223.42	Professional	TC	$151.93	$201.08	$223.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.74 / $137.37 / $225.09	Professional		$57.74	$137.37	$225.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.66 / $400.02 / $638.55	Professional		$212.66	$400.02	$638.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.29 / $95.03 / $142.16	Professional	26	$61.29	$95.03	$142.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.13 / $295.07 / $500.00	Professional	TC	$155.13	$295.07	$500.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $109.49 / $123.92	Professional	26	$55.84	$109.49	$123.92
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $232.55 / $232.55 / $296.50	Professional	TC	$232.55	$232.55	$296.50
United Facility/Professional Professional Modifier Low / Median / High Price $219.03 / $373.85 / $483.15	Professional		$219.03	$373.85	$483.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.74 / $80.09 / $126.67	Professional	26	$62.74	$80.09	$126.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.41 / $248.25 / $436.53	Professional	TC	$145.41	$248.25	$436.53