Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $79.43 / $83.18	Facility	26	$56.23	$79.43	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $407.38	Professional		$134.90	$177.83	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $131.83	Professional	26	$48.98	$61.66	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $234.42	Professional	TC	$83.18	$120.23	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $204.17	Professional		$128.82	$128.82	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $79.43 / $95.50	Professional	26	$38.90	$79.43	$95.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $93.33 / $120.23	Professional	TC	$93.33	$93.33	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $162.18 / $204.17	Professional		$141.25	$162.18	$204.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $64.57 / $83.18	Professional	26	$56.23	$64.57	$83.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $97.72 / $123.03	Professional	TC	$85.11	$97.72	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $100.00 / $194.98	Professional		$50.12	$100.00	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $275.42 / $436.52	Professional		$128.82	$275.42	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $74.13 / $123.03	Professional	26	$50.12	$74.13	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $173.78 / $331.13	Professional	TC	$79.43	$173.78	$331.13
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $97.72 / $120.23	Professional	26	$66.07	$97.72	$120.23
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	TC	$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $416.87	Professional		$128.82	$218.78	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $60.26 / $100.00	Professional	26	$47.86	$60.26	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $125.89 / $288.40	Professional	TC	$79.43	$125.89	$288.40