Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.89 / $162.26 / $177.97	Facility	26	$111.89	$162.26	$177.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.40 / $669.75 / $769.97	Professional		$455.40	$669.75	$769.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.00 / $157.90 / $209.95	Professional	26	$110.00	$157.90	$209.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $521.11 / $640.26	Professional	TC	$335.00	$521.11	$640.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $352.42 / $611.98 / $618.09	Professional		$352.42	$611.98	$618.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.00 / $164.56 / $187.44	Professional	26	$26.00	$164.56	$187.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $464.32 / $614.54 / $682.82	Professional		$464.32	$614.54	$682.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.13 / $145.76 / $161.96	Professional	26	$110.13	$145.76	$161.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.18 / $468.77 / $520.86	Professional	TC	$354.18	$468.77	$520.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $434.14 / $738.76 / $1,224.78	Professional		$434.14	$738.76	$1,224.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.29 / $146.99 / $221.70	Professional	26	$98.29	$146.99	$221.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $335.85 / $566.91 / $1,112.30	Professional	TC	$335.85	$566.91	$1,112.30
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $703.78 / $703.78 / $710.80	Professional		$703.78	$703.78	$710.80
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $129.41 / $193.03 / $215.56	Professional	26	$129.41	$193.03	$215.56
United Facility/Professional Professional Modifier Low / Median / High Price $447.57 / $747.90 / $1,201.33	Professional		$447.57	$747.90	$1,201.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.94 / $120.68 / $207.14	Professional	26	$97.94	$120.68	$207.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $327.80 / $575.85 / $949.93	Professional	TC	$327.80	$575.85	$949.93