Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.63 / $72.80 / $105.09	Facility	26	$51.63	$72.80	$105.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.21 / $221.75 / $353.78	Professional		$168.21	$221.75	$353.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $62.42 / $98.00	Professional	26	$44.14	$62.42	$98.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.79 / $177.61 / $291.63	Professional	TC	$105.79	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.65 / $219.65 / $219.65	Professional		$219.65	$219.65	$219.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $74.17 / $86.49	Professional	26	$35.19	$74.17	$86.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.60 / $162.60 / $162.60	Professional	TC	$162.60	$162.60	$162.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.34 / $228.10 / $253.44	Professional		$172.34	$228.10	$253.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.55 / $68.23 / $75.81	Professional	26	$51.55	$68.23	$75.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.79 / $159.87 / $177.63	Professional	TC	$120.79	$159.87	$177.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $83.20 / $149.53	Professional		$46.04	$83.20	$149.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.94 / $275.92 / $447.58	Professional		$162.94	$275.92	$447.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.77 / $73.26 / $103.31	Professional	26	$45.77	$73.26	$103.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.07 / $187.73 / $328.20	Professional	TC	$113.07	$187.73	$328.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $252.60 / $252.60 / $252.60	Professional		$252.60	$252.60	$252.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $42.25 / $87.32 / $99.46	Professional	26	$42.25	$87.32	$99.46
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $186.99 / $186.99 / $186.99	Professional	TC	$186.99	$186.99	$186.99
United Facility/Professional Professional Modifier Low / Median / High Price $144.12 / $246.71 / $339.26	Professional		$144.12	$246.71	$339.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.38 / $57.37 / $99.19	Professional	26	$45.38	$57.37	$99.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.13 / $160.37 / $280.30	Professional	TC	$96.13	$160.37	$280.30