Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $89.13 / $93.33	Facility	26	$63.10	$89.13	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $371.54	Professional		$169.82	$234.42	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $173.78	Professional	26	$51.29	$72.44	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $173.78 / $281.84	Professional	TC	$112.20	$173.78	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $109.65	Professional	26	$43.65	$75.86	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $316.23	Professional		$218.78	$251.19	$316.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $93.33	Professional	26	$63.10	$72.44	$93.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $229.09	Professional	TC	$154.88	$177.83	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $213.80	Professional		$56.23	$102.33	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $346.74 / $537.03	Professional		$173.78	$346.74	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $83.18 / $138.04	Professional	26	$56.23	$83.18	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $245.47 / $398.11	Professional	TC	$128.82	$245.47	$398.11
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $104.71 / $141.25	Professional	26	$51.29	$104.71	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $489.78	Professional		$173.78	$295.12	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $112.20	Professional	26	$53.70	$67.61	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $186.21 / $354.81	Professional	TC	$117.49	$186.21	$354.81