Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.20 / $176.61 / $190.94	Facility	26	$119.20	$176.61	$190.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.97 / $543.46 / $778.38	Professional		$412.97	$543.46	$778.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.00 / $176.40 / $363.80	Professional	26	$110.00	$176.40	$363.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $270.31 / $375.25 / $606.00	Professional	TC	$270.31	$375.25	$606.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $483.62 / $488.46 / $584.96	Professional		$483.62	$488.46	$584.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.38 / $175.30 / $195.26	Professional	26	$81.38	$175.30	$195.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $262.58 / $331.49 / $354.21	Professional	TC	$262.58	$331.49	$354.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $357.90 / $473.70 / $526.33	Professional		$357.90	$473.70	$526.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.32 / $155.28 / $172.53	Professional	26	$117.32	$155.28	$172.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.58 / $318.42 / $353.80	Professional	TC	$240.58	$318.42	$353.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.29 / $211.76 / $367.50	Professional		$106.29	$211.76	$367.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.79 / $704.87 / $1,597.24	Professional		$335.79	$704.87	$1,597.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.87 / $171.10 / $236.57	Professional	26	$104.87	$171.10	$236.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.25 / $457.31 / $1,381.81	Professional	TC	$228.25	$457.31	$1,381.81
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $556.16 / $561.73 / $672.70	Professional		$556.16	$561.73	$672.70
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $103.05 / $205.63 / $247.25	Professional	26	$103.05	$205.63	$247.25
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $301.98 / $381.21 / $407.34	Professional	TC	$301.98	$381.21	$407.34
United Facility/Professional Professional Modifier Low / Median / High Price $347.48 / $614.16 / $1,271.64	Professional		$347.48	$614.16	$1,271.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.91 / $149.18 / $225.72	Professional	26	$107.91	$149.18	$225.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.74 / $391.65 / $952.84	Professional	TC	$235.74	$391.65	$952.84