Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.05 / $88.65 / $98.64	Facility	26	$76.05	$88.65	$98.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.75 / $308.80 / $465.28	Professional		$191.75	$308.80	$465.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $76.11 / $100.71	Professional	26	$52.78	$76.11	$100.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.53 / $227.00 / $376.52	Professional	TC	$132.53	$227.00	$376.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.31 / $129.31 / $290.93	Professional		$129.31	$129.31	$290.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.97 / $92.71 / $105.61	Professional	26	$42.97	$92.71	$105.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.92 / $85.92 / $85.92	Professional	TC	$85.92	$85.92	$85.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.36 / $287.68 / $319.64	Professional		$217.36	$287.68	$319.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.78 / $83.09 / $92.32	Professional	26	$62.78	$83.09	$92.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.58 / $204.59 / $227.32	Professional	TC	$154.58	$204.59	$227.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $112.25 / $194.60	Professional		$56.22	$112.25	$194.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.89 / $339.90 / $520.36	Professional		$202.89	$339.90	$520.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.95 / $84.21 / $125.90	Professional	26	$55.95	$84.21	$125.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.65 / $239.74 / $395.00	Professional	TC	$146.65	$239.74	$395.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $148.71 / $148.71 / $334.57	Professional		$148.71	$148.71	$334.57
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $73.34 / $108.76 / $135.69	Professional	26	$73.34	$108.76	$135.69
United Facility/Professional Professional Modifier Low / Median / High Price $181.06 / $308.30 / $420.72	Professional		$181.06	$308.30	$420.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.53 / $74.93 / $113.97	Professional	26	$55.53	$74.93	$113.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.77 / $210.71 / $356.21	Professional	TC	$122.77	$210.71	$356.21