Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $75.86 / $85.11	Facility	26	$52.48	$75.86	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $436.52	Professional		$128.82	$177.83	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $60.26 / $141.25	Professional	26	$43.65	$60.26	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $275.42	Professional	TC	$83.18	$120.23	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $199.53 / $234.42	Professional		$102.33	$199.53	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $85.11	Professional	26	$35.48	$52.48	$85.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $194.98 / $251.19	Professional		$169.82	$194.98	$251.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $58.88 / $75.86	Professional	26	$51.29	$58.88	$75.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $138.04 / $177.83	Professional	TC	$120.23	$138.04	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $102.33 / $190.55	Professional		$45.71	$102.33	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $281.84 / $446.68	Professional		$141.25	$281.84	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $72.44 / $112.20	Professional	26	$45.71	$72.44	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $194.98 / $331.13	Professional	TC	$102.33	$194.98	$331.13
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $257.04	Professional		$229.09	$229.09	$257.04
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $89.13 / $102.33	Professional	26	$40.74	$89.13	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $416.87	Professional		$138.04	$234.42	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $57.54 / $102.33	Professional	26	$44.67	$57.54	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $144.54 / $288.40	Professional	TC	$93.33	$144.54	$288.40