Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $85.11 / $89.13	Facility	26	$60.26	$85.11	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $213.80 / $380.19	Professional		$125.89	$213.80	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $165.96	Professional	26	$51.29	$64.57	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $169.82 / $288.40	Professional	TC	$114.82	$169.82	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $69.18 / $100.00	Professional	26	$40.74	$69.18	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $316.23	Professional		$213.80	$245.47	$316.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $69.18 / $87.10	Professional	26	$60.26	$69.18	$87.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $229.09	Professional	TC	$154.88	$177.83	$229.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $123.03 / $245.47	Professional		$53.70	$123.03	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $323.59 / $478.63	Professional		$169.82	$323.59	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $79.43 / $125.89	Professional	26	$52.48	$79.43	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $234.42 / $346.74	Professional	TC	$128.82	$234.42	$346.74
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $104.71 / $117.49	Professional	26	$69.18	$104.71	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $436.52	Professional		$169.82	$275.42	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $107.15	Professional	26	$51.29	$64.57	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $186.21 / $338.84	Professional	TC	$120.23	$186.21	$338.84