Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.49 / $77.48 / $104.61	Facility	26	$63.49	$77.48	$104.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.62 / $226.07 / $353.78	Professional		$168.62	$226.07	$353.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $72.75 / $124.75	Professional	26	$44.14	$72.75	$124.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.18 / $177.61 / $291.63	Professional	TC	$106.18	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.45 / $231.78 / $283.69	Professional		$197.45	$231.78	$283.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.63 / $77.45 / $86.49	Professional	26	$36.63	$77.45	$86.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.01 / $127.98 / $163.50	Professional	TC	$123.01	$127.98	$163.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.00 / $232.94 / $258.82	Professional		$176.00	$232.94	$258.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $72.62 / $80.69	Professional	26	$54.87	$72.62	$80.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.13 / $160.32 / $178.13	Professional	TC	$121.13	$160.32	$178.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $83.52 / $149.90	Professional		$46.04	$83.52	$149.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.50 / $276.57 / $447.58	Professional		$166.50	$276.57	$447.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.74 / $73.89 / $103.31	Professional	26	$48.74	$73.89	$103.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.51 / $188.76 / $328.20	Professional	TC	$113.51	$188.76	$328.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $227.07 / $227.07 / $326.24	Professional		$227.07	$227.07	$326.24
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $48.05 / $90.45 / $99.46	Professional	26	$48.05	$90.45	$99.46
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $141.46 / $141.46 / $147.18	Professional	TC	$141.46	$141.46	$147.18
United Facility/Professional Professional Modifier Low / Median / High Price $144.12 / $249.58 / $374.90	Professional		$144.12	$249.58	$374.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.02 / $67.11 / $103.41	Professional	26	$47.02	$67.11	$103.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.13 / $160.37 / $281.31	Professional	TC	$96.13	$160.37	$281.31