Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.08 / $73.83 / $99.02	Facility	26	$63.08	$73.83	$99.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.81 / $221.44 / $379.63	Professional		$146.81	$221.44	$379.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $72.75 / $171.70	Professional	26	$46.61	$72.75	$171.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.38 / $177.61 / $291.63	Professional	TC	$105.38	$177.61	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.97 / $196.97 / $204.95	Professional		$196.97	$196.97	$204.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $75.93 / $86.49	Professional	26	$35.19	$75.93	$86.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $127.49 / $127.49 / $161.25	Professional	TC	$127.49	$127.49	$161.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.67 / $227.21 / $252.46	Professional		$171.67	$227.21	$252.46
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 $120.12 / $158.99 / $176.65	Professional	TC	$120.12	$158.99	$176.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $83.20 / $149.53	Professional		$46.04	$83.20	$149.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $264.95 / $385.46	Professional		$162.38	$264.95	$385.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.11 / $69.66 / $103.31	Professional	26	$46.11	$69.66	$103.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.07 / $186.17 / $275.16	Professional	TC	$113.07	$186.17	$275.16
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $114.39 / $226.52 / $235.69	Professional		$114.39	$226.52	$235.69
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $80.70 / $89.79 / $99.46	Professional	26	$80.70	$89.79	$99.46
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $146.61 / $146.61 / $185.44	Professional	TC	$146.61	$146.61	$185.44
United Facility/Professional Professional Modifier Low / Median / High Price $139.52 / $240.44 / $332.21	Professional		$139.52	$240.44	$332.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.13 / $54.91 / $93.19	Professional	26	$46.13	$54.91	$93.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.40 / $159.28 / $242.79	Professional	TC	$93.40	$159.28	$242.79