Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $120.23 / $123.03	Facility	26	$100.00	$120.23	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $741.31	Professional		$194.98	$346.74	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $239.88	Professional	26	$64.57	$112.20	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $204.17 / $436.52	Professional	TC	$123.03	$204.17	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $288.40 / $338.84	Professional		$141.25	$288.40	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $125.89	Professional	26	$52.48	$72.44	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $95.50 / $194.98	Professional	TC	$79.43	$95.50	$194.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $309.03	Professional		$213.80	$245.47	$309.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $112.20	Professional	26	$75.86	$87.10	$112.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $154.88 / $199.53	Professional	TC	$134.90	$154.88	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $147.91 / $281.84	Professional		$69.18	$147.91	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $457.09 / $794.33	Professional		$194.98	$457.09	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $109.65 / $169.82	Professional	26	$67.61	$109.65	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $275.42 / $616.60	Professional	TC	$123.03	$275.42	$616.60
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $338.84 / $389.05	Professional		$165.96	$338.84	$389.05
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $131.83 / $147.91	Professional	26	$63.10	$131.83	$147.91
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $208.93 / $223.87	Professional	TC	$169.82	$208.93	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $676.08	Professional		$194.98	$331.13	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $83.18 / $144.54	Professional	26	$66.07	$83.18	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $208.93 / $549.54	Professional	TC	$125.89	$208.93	$549.54