Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.63 / $72.80 / $88.18	Facility	26	$51.63	$72.80	$88.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $221.44 / $379.63	Professional		$171.00	$221.44	$379.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $71.62 / $177.65	Professional	26	$43.82	$71.62	$177.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.73 / $177.61 / $291.63	Professional	TC	$126.73	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $242.02 / $269.88 / $274.98	Professional		$242.02	$269.88	$274.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.74 / $75.93 / $86.49	Professional	26	$36.74	$75.93	$86.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $161.25 / $182.00 / $182.00	Professional	TC	$161.25	$182.00	$182.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.35 / $226.78 / $251.98	Professional		$171.35	$226.78	$251.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.55 / $68.23 / $75.81	Professional	26	$51.55	$68.23	$75.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $119.80 / $158.55 / $176.17	Professional	TC	$119.80	$158.55	$176.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $113.88 / $184.39	Professional		$46.04	$113.88	$184.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $265.29 / $385.46	Professional		$162.38	$265.29	$385.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.11 / $69.89 / $103.31	Professional	26	$46.11	$69.89	$103.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.11 / $186.68 / $280.00	Professional	TC	$115.11	$186.68	$280.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $134.96 / $278.32 / $316.23	Professional		$134.96	$278.32	$316.23
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.30 / $89.79 / $99.46	Professional	26	$85.30	$89.79	$99.46
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $185.44 / $185.44 / $192.71	Professional	TC	$185.44	$185.44	$192.71
United Facility/Professional Professional Modifier Low / Median / High Price $160.29 / $251.72 / $338.60	Professional		$160.29	$251.72	$338.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.02 / $58.20 / $94.19	Professional	26	$47.02	$58.20	$94.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.79 / $189.16 / $273.66	Professional	TC	$111.79	$189.16	$273.66