Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.63 / $74.87 / $105.09	Facility	26	$51.63	$74.87	$105.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.96 / $221.75 / $382.75	Professional		$154.96	$221.75	$382.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $62.42 / $124.75	Professional	26	$44.14	$62.42	$124.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.37 / $177.61 / $291.63	Professional	TC	$105.37	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.49 / $198.46 / $219.12	Professional		$196.49	$198.46	$219.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $74.44 / $86.49	Professional	26	$34.89	$74.44	$86.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.50 / $63.50 / $63.50	Professional	TC	$63.50	$63.50	$63.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.67 / $227.21 / $252.46	Professional		$171.67	$227.21	$252.46
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 $120.12 / $158.99 / $176.65	Professional	TC	$120.12	$158.99	$176.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $82.88 / $149.15	Professional		$46.04	$82.88	$149.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.35 / $275.27 / $447.58	Professional		$162.35	$275.27	$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 $112.62 / $186.17 / $328.20	Professional	TC	$112.62	$186.17	$328.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $225.96 / $228.23 / $251.99	Professional		$225.96	$228.23	$251.99
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $44.90 / $89.07 / $99.46	Professional	26	$44.90	$89.07	$99.46
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $73.03 / $73.03 / $73.03	Professional	TC	$73.03	$73.03	$73.03
United Facility/Professional Professional Modifier Low / Median / High Price $144.76 / $246.05 / $366.74	Professional		$144.76	$246.05	$366.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.42 / $58.10 / $98.91	Professional	26	$45.42	$58.10	$98.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.61 / $168.92 / $237.30	Professional	TC	$97.61	$168.92	$237.30