Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.47 / $79.03 / $88.18	Facility	26	$67.47	$79.03	$88.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $225.12 / $351.09	Professional		$171.00	$225.12	$351.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $72.20 / $114.93	Professional	26	$47.71	$72.20	$114.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.98 / $158.41 / $285.50	Professional	TC	$104.98	$158.41	$285.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.33 / $204.33 / $225.59	Professional		$204.33	$204.33	$225.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $82.84 / $94.36	Professional	26	$56.22	$82.84	$94.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.32 / $185.72 / $206.35	Professional		$140.32	$185.72	$206.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.97 / $74.08 / $82.31	Professional	26	$55.97	$74.08	$82.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.35 / $111.64 / $124.04	Professional	TC	$84.35	$111.64	$124.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.23 / $82.23 / $153.36	Professional		$50.23	$82.23	$153.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.76 / $258.89 / $441.67	Professional		$129.76	$258.89	$441.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.72 / $74.91 / $112.20	Professional	26	$49.72	$74.91	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.03 / $148.13 / $328.20	Professional	TC	$80.03	$148.13	$328.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $234.98 / $234.98 / $259.43	Professional		$234.98	$234.98	$259.43
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $92.24 / $97.16 / $108.51	Professional	26	$92.24	$97.16	$108.51
United Facility/Professional Professional Modifier Low / Median / High Price $135.32 / $238.39 / $342.40	Professional		$135.32	$238.39	$342.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.34 / $68.48 / $101.86	Professional	26	$49.34	$68.48	$101.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.03 / $140.59 / $264.14	Professional	TC	$81.03	$140.59	$264.14