Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.93 / $177.18 / $190.12	Facility	26	$146.93	$177.18	$190.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.54 / $542.30 / $738.63	Professional		$361.54	$542.30	$738.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.31 / $176.40 / $380.80	Professional	26	$120.31	$176.40	$380.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.47 / $374.08 / $640.26	Professional	TC	$269.47	$374.08	$640.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $476.56 / $502.18 / $583.30	Professional		$476.56	$502.18	$583.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.96 / $178.81 / $199.67	Professional	26	$82.96	$178.81	$199.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $310.80 / $323.37 / $353.12	Professional	TC	$310.80	$323.37	$353.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $357.24 / $472.82 / $525.36	Professional		$357.24	$472.82	$525.36
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 $239.92 / $317.55 / $352.83	Professional	TC	$239.92	$317.55	$352.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.29 / $211.12 / $366.75	Professional		$106.29	$211.12	$366.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.66 / $703.55 / $1,581.88	Professional		$334.66	$703.55	$1,581.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.20 / $169.53 / $236.57	Professional	26	$105.20	$169.53	$236.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.63 / $456.03 / $1,381.81	Professional	TC	$227.63	$456.03	$1,381.81
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $560.60 / $577.51 / $670.81	Professional		$560.60	$577.51	$670.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $138.25 / $207.38 / $229.62	Professional	26	$138.25	$207.38	$229.62
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $357.42 / $371.88 / $406.09	Professional	TC	$357.42	$371.88	$406.09
United Facility/Professional Professional Modifier Low / Median / High Price $354.17 / $588.37 / $1,191.24	Professional		$354.17	$588.37	$1,191.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.05 / $133.27 / $214.43	Professional	26	$108.05	$133.27	$214.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.87 / $390.54 / $952.84	Professional	TC	$224.87	$390.54	$952.84