Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.04 / $84.50 / $89.81	Facility	26	$60.04	$84.50	$89.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.84 / $305.58 / $470.68	Professional		$244.84	$305.58	$470.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $76.43 / $98.00	Professional	26	$51.30	$76.43	$98.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.49 / $221.08 / $375.33	Professional	TC	$194.49	$221.08	$375.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $343.20 / $343.20 / $343.20	Professional		$343.20	$343.20	$343.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.34 / $88.31 / $100.59	Professional	26	$50.34	$88.31	$100.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $330.34 / $330.34 / $330.34	Professional	TC	$330.34	$330.34	$330.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.03 / $295.18 / $327.98	Professional		$223.03	$295.18	$327.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.83 / $79.19 / $87.99	Professional	26	$59.83	$79.19	$87.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.19 / $215.99 / $239.99	Professional	TC	$163.19	$215.99	$239.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.54 / $171.95 / $259.64	Professional		$53.54	$171.95	$259.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.96 / $338.55 / $519.09	Professional		$199.96	$338.55	$519.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.03 / $80.27 / $119.57	Professional	26	$53.03	$80.27	$119.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.63 / $262.85 / $385.00	Professional	TC	$146.63	$262.85	$385.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $394.68 / $394.68 / $394.68	Professional		$394.68	$394.68	$394.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $98.19 / $101.56 / $128.80	Professional	26	$98.19	$101.56	$128.80
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $379.89 / $379.89 / $379.89	Professional	TC	$379.89	$379.89	$379.89
United Facility/Professional Professional Modifier Low / Median / High Price $216.29 / $328.14 / $473.61	Professional		$216.29	$328.14	$473.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.90 / $84.20 / $108.57	Professional	26	$52.90	$84.20	$108.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.92 / $237.40 / $356.34	Professional	TC	$167.92	$237.40	$356.34