Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $159.86 / $187.10 / $206.78	Facility	26	$159.86	$187.10	$206.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.72 / $544.62 / $777.61	Professional		$413.72	$544.62	$777.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.14 / $176.40 / $363.80	Professional	26	$112.14	$176.40	$363.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.67 / $375.20 / $462.42	Professional	TC	$265.67	$375.20	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $484.58 / $484.58 / $540.38	Professional		$484.58	$484.58	$540.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.41 / $175.30 / $195.26	Professional	26	$89.41	$175.30	$195.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $312.72 / $312.72 / $526.58	Professional	TC	$312.72	$312.72	$526.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.90 / $475.01 / $527.79	Professional		$358.90	$475.01	$527.79
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 $241.58 / $319.73 / $355.26	Professional	TC	$241.58	$319.73	$355.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.29 / $212.42 / $368.24	Professional		$106.29	$212.42	$368.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $336.09 / $702.83 / $1,597.24	Professional		$336.09	$702.83	$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 $229.20 / $458.60 / $1,381.81	Professional	TC	$229.20	$458.60	$1,381.81
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $562.83 / $579.80 / $621.44	Professional		$562.83	$579.80	$621.44
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $102.82 / $205.63 / $229.62	Professional	26	$102.82	$205.63	$229.62
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $605.57 / $605.57 / $605.57	Professional	TC	$605.57	$605.57	$605.57
United Facility/Professional Professional Modifier Low / Median / High Price $348.13 / $619.72 / $1,271.18	Professional		$348.13	$619.72	$1,271.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.91 / $146.62 / $226.68	Professional	26	$107.91	$146.62	$226.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.14 / $392.75 / $959.14	Professional	TC	$226.14	$392.75	$959.14