Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.83 / $112.65 / $131.34	Facility	26	$84.83	$112.65	$131.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.34 / $475.00 / $1,064.80	Professional		$231.34	$475.00	$1,064.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $112.66 / $306.00	Professional	26	$65.42	$112.66	$306.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,218.00 / $1,218.00 / $1,218.00	Professional	50	$1,218.00	$1,218.00	$1,218.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $183.96 / $275.00	Professional	52	$125.00	$183.96	$275.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $319.07 / $474.87	Professional	TC	$187.50	$319.07	$474.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $296.45 / $319.66 / $349.07	Professional		$296.45	$319.66	$349.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.74 / $103.37 / $117.75	Professional	26	$48.74	$103.37	$117.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $209.31 / $214.22 / $253.00	Professional	TC	$209.31	$214.22	$253.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.06 / $295.23 / $328.03	Professional		$223.06	$295.23	$328.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.92 / $92.55 / $102.83	Professional	26	$69.92	$92.55	$102.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.13 / $202.68 / $225.20	Professional	TC	$153.13	$202.68	$225.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.68 / $139.99 / $233.80	Professional		$62.68	$139.99	$233.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.63 / $440.04 / $758.79	Professional		$211.63	$440.04	$758.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.74 / $97.88 / $142.63	Professional	26	$61.74	$97.88	$142.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.29 / $297.95 / $616.40	Professional	TC	$145.29	$297.95	$616.40
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $353.31 / $367.61 / $401.43	Professional		$353.31	$367.61	$401.43
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $115.44 / $122.66 / $135.41	Professional	26	$115.44	$122.66	$135.41
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $240.71 / $246.35 / $290.95	Professional	TC	$240.71	$246.35	$290.95
United Facility/Professional Professional Modifier Low / Median / High Price $214.82 / $382.74 / $581.70	Professional		$214.82	$382.74	$581.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $84.44 / $127.64	Professional	26	$64.59	$84.44	$127.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.87 / $249.16 / $540.45	Professional	TC	$146.87	$249.16	$540.45