Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.53 / $74.53 / $81.12	Facility	26	$74.53	$74.53	$81.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.34 / $177.98 / $233.05	Professional		$138.34	$177.98	$233.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $74.53 / $121.02	Professional	26	$48.28	$74.53	$121.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.39 / $119.70 / $154.18	Professional	TC	$88.39	$119.70	$154.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.45 / $210.85 / $210.85	Professional		$120.45	$210.85	$210.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $82.27 / $90.00	Professional	26	$37.88	$82.27	$90.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $125.76 / $133.29 / $153.93	Professional	TC	$125.76	$133.29	$153.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.66 / $166.32 / $184.80	Professional		$125.66	$166.32	$184.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.43 / $60.13 / $66.81	Professional	26	$45.43	$60.13	$66.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.23 / $106.19 / $117.99	Professional	TC	$80.23	$106.19	$117.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.88 / $87.14 / $158.38	Professional		$49.88	$87.14	$158.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.87 / $198.51 / $295.41	Professional		$128.87	$198.51	$295.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.87 / $73.01 / $110.05	Professional	26	$48.87	$73.01	$110.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.39 / $125.54 / $184.63	Professional	TC	$82.39	$125.54	$184.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $242.48 / $242.48 / $242.48	Professional		$242.48	$242.48	$242.48
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $96.11 / $107.77	Professional	26	$64.06	$96.11	$107.77
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $147.33 / $153.28 / $177.02	Professional	TC	$147.33	$153.28	$177.02
United Facility/Professional Professional Modifier Low / Median / High Price $137.52 / $178.54 / $268.72	Professional		$137.52	$178.54	$268.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.69 / $59.52 / $98.10	Professional	26	$48.69	$59.52	$98.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.10 / $106.62 / $168.33	Professional	TC	$90.10	$106.62	$168.33