Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $104.71 / $131.83	Facility	26	$85.11	$104.71	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $316.23 / $1,000.00	Professional		$102.33	$316.23	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $213.80	Professional	26	$61.66	$107.15	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $234.42 / $467.74	Professional	TC	$141.25	$234.42	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $346.74	Professional		$138.04	$199.53	$346.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $70.79 / $112.20	Professional	26	$47.86	$70.79	$112.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $295.12 / $602.56	Professional	50	$295.12	$295.12	$602.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $204.17 / $245.47	Professional	TC	$107.15	$204.17	$245.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $257.04 / $331.13	Professional		$223.87	$257.04	$331.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $102.33	Professional	26	$69.18	$79.43	$102.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $173.78 / $223.87	Professional	TC	$154.88	$173.78	$223.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $151.36 / $302.00	Professional		$63.10	$151.36	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $467.74 / $758.58	Professional		$186.21	$467.74	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $93.33 / $154.88	Professional	26	$61.66	$93.33	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $309.03 / $630.96	Professional	TC	$141.25	$309.03	$630.96
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $363.08 / $398.11	Professional		$338.84	$363.08	$398.11
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $120.23 / $138.04	Professional	26	$81.28	$120.23	$138.04
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $251.19 / $275.42	Professional	TC	$234.42	$251.19	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $346.74 / $707.95	Professional		$204.17	$346.74	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $128.82	Professional	26	$60.26	$75.86	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $588.84	Professional	TC	$141.25	$229.09	$588.84