Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $85.11 / $89.13	Facility	26	$60.26	$85.11	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $446.68	Professional		$194.98	$275.42	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $131.83	Professional	26	$51.29	$72.44	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $338.84	Professional	TC	$147.91	$213.80	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $389.05	Professional		$346.74	$346.74	$389.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $85.11 / $97.72	Professional	26	$40.74	$85.11	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	TC	$257.04	$257.04	$257.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $257.04 / $331.13	Professional		$223.87	$257.04	$331.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $69.18 / $87.10	Professional	26	$60.26	$69.18	$87.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $186.21 / $239.88	Professional	TC	$162.18	$186.21	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $186.21 / $354.81	Professional		$53.70	$186.21	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $549.54	Professional		$199.53	$363.08	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $79.43 / $131.83	Professional	26	$52.48	$79.43	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $269.15 / $389.05	Professional	TC	$147.91	$269.15	$389.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $446.68	Professional		$398.11	$398.11	$446.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $104.71 / $114.82	Professional	26	$97.72	$104.71	$114.82
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $295.12 / $295.12	Professional	TC	$295.12	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $489.78	Professional		$213.80	$309.03	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $107.15	Professional	26	$51.29	$64.57	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $229.09 / $371.54	Professional	TC	$158.49	$229.09	$371.54