Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $102.33 / $112.20	Facility	26	$70.79	$102.33	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $371.54 / $870.96	Professional		$154.88	$371.54	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $112.20 / $213.80	Professional	26	$61.66	$112.20	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $263.03 / $436.52	Professional	TC	$162.18	$263.03	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $436.52	Professional		$162.18	$199.53	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $79.43 / $117.49	Professional	26	$47.86	$79.43	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $125.89 / $295.12	Professional	TC	$104.71	$125.89	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $371.54	Professional		$251.19	$288.40	$371.54
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 $181.97 / $208.93 / $269.15	Professional	TC	$181.97	$208.93	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $173.78 / $323.59	Professional		$63.10	$173.78	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $489.78 / $741.31	Professional		$239.88	$489.78	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $151.36	Professional	26	$61.66	$91.20	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $363.08 / $630.96	Professional	TC	$169.82	$363.08	$630.96
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $524.81	Professional		$389.05	$389.05	$524.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $120.23 / $147.91	Professional	26	$114.82	$120.23	$147.91
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $269.15 / $269.15	Professional	TC	$269.15	$269.15	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $407.38 / $707.95	Professional		$229.09	$407.38	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $75.86 / $125.89	Professional	26	$58.88	$75.86	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $602.56	Professional	TC	$165.96	$281.84	$602.56