Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.84 / $104.18 / $112.12	Facility	26	$83.84	$104.18	$112.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $285.72 / $475.00 / $655.50	Professional		$285.72	$475.00	$655.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.84 / $112.12 / $189.00	Professional	26	$83.84	$112.12	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $279.51 / $344.38 / $482.24	Professional	TC	$279.51	$344.38	$482.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $449.68 / $449.68 / $467.87	Professional		$449.68	$449.68	$467.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.00 / $105.00 / $117.75	Professional	26	$70.00	$105.00	$117.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $372.36 / $372.36 / $372.36	Professional	TC	$372.36	$372.36	$372.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.64 / $450.85 / $500.94	Professional		$340.64	$450.85	$500.94
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.59 / $92.12 / $102.35	Professional	26	$69.59	$92.12	$102.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $271.04 / $358.73 / $398.59	Professional	TC	$271.04	$358.73	$398.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.68 / $236.56 / $344.15	Professional		$62.68	$236.56	$344.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.45 / $517.11 / $737.93	Professional		$310.45	$517.11	$737.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.74 / $92.30 / $139.85	Professional	26	$61.74	$92.30	$139.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.61 / $429.93 / $624.60	Professional	TC	$248.61	$429.93	$624.60
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $517.13 / $517.13 / $538.04	Professional		$517.13	$517.13	$538.04
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $80.50 / $120.75 / $135.41	Professional	26	$80.50	$120.75	$135.41
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $428.21 / $428.21 / $428.21	Professional	TC	$428.21	$428.21	$428.21
United Facility/Professional Professional Modifier Low / Median / High Price $329.42 / $509.13 / $679.16	Professional		$329.42	$509.13	$679.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $78.80 / $127.04	Professional	26	$61.72	$78.80	$127.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.50 / $427.85 / $543.88	Professional	TC	$251.50	$427.85	$543.88