Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.04 / $84.50 / $89.81	Facility	26	$60.04	$84.50	$89.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.96 / $305.58 / $438.99	Professional		$188.96	$305.58	$438.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $77.01 / $90.99	Professional	26	$51.30	$77.01	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.53 / $221.08 / $368.85	Professional	TC	$132.53	$221.08	$368.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $90.07 / $91.62	Professional	26	$59.90	$90.07	$91.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $256.75 / $256.75 / $256.75	Professional	TC	$256.75	$256.75	$256.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.40 / $285.08 / $316.77	Professional		$215.40	$285.08	$316.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.83 / $79.19 / $87.99	Professional	26	$59.83	$79.19	$87.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.57 / $205.90 / $228.78	Professional	TC	$155.57	$205.90	$228.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.54 / $112.25 / $191.43	Professional		$53.54	$112.25	$191.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.85 / $321.24 / $433.68	Professional		$200.85	$321.24	$433.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.03 / $80.27 / $118.14	Professional	26	$53.03	$80.27	$118.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.52 / $236.15 / $343.67	Professional	TC	$147.52	$236.15	$343.67
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.55 / $103.58 / $115.68	Professional	26	$69.55	$103.58	$115.68
United Facility/Professional Professional Modifier Low / Median / High Price $174.13 / $295.87 / $416.33	Professional		$174.13	$295.87	$416.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.90 / $72.97 / $108.57	Professional	26	$52.90	$72.97	$108.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.75 / $206.50 / $301.20	Professional	TC	$123.75	$206.50	$301.20