Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.09 / $173.84 / $182.29	Facility	26	$140.09	$173.84	$182.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.49 / $573.33 / $906.15	Professional		$407.49	$573.33	$906.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.90 / $170.05 / $380.80	Professional	26	$100.90	$170.05	$380.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $291.02 / $412.31 / $476.73	Professional	TC	$291.02	$412.31	$476.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $507.17 / $576.23 / $576.23	Professional		$507.17	$576.23	$576.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.92 / $171.27 / $187.03	Professional	26	$95.92	$171.27	$187.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $342.56 / $356.42 / $363.11	Professional	TC	$342.56	$356.42	$363.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.32 / $504.68 / $560.76	Professional		$381.32	$504.68	$560.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.91 / $149.44 / $166.05	Professional	26	$112.91	$149.44	$166.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.39 / $355.24 / $394.71	Professional	TC	$268.39	$355.24	$394.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.81 / $232.65 / $386.03	Professional		$101.81	$232.65	$386.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.05 / $722.98 / $1,519.76	Professional		$381.05	$722.98	$1,519.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.21 / $149.97 / $223.82	Professional	26	$103.21	$149.97	$223.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.08 / $520.47 / $1,370.80	Professional	TC	$274.08	$520.47	$1,370.80
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $589.08 / $650.39 / $732.99	Professional		$589.08	$650.39	$732.99
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $189.30 / $204.84 / $219.94	Professional	26	$189.30	$204.84	$219.94
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $393.94 / $409.88 / $417.58	Professional	TC	$393.94	$409.88	$417.58
United Facility/Professional Professional Modifier Low / Median / High Price $368.86 / $651.35 / $1,243.72	Professional		$368.86	$651.35	$1,243.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.71 / $123.07 / $205.39	Professional	26	$102.71	$123.07	$205.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.56 / $445.96 / $945.20	Professional	TC	$250.56	$445.96	$945.20