Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.62 / $103.95 / $121.64	Facility	26	$83.62	$103.95	$121.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.00 / $475.00 / $963.49	Professional		$306.00	$475.00	$963.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.03 / $117.26 / $216.80	Professional	26	$81.03	$117.26	$216.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $244.41 / $335.00 / $472.35	Professional	TC	$244.41	$335.00	$472.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $334.85 / $334.85 / $459.05	Professional		$334.85	$334.85	$459.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $102.88 / $114.60	Professional	26	$47.71	$102.88	$114.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $373.26 / $373.26 / $373.26	Professional	TC	$373.26	$373.26	$373.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.34 / $331.33 / $368.14	Professional		$250.34	$331.33	$368.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.26 / $91.67 / $101.85	Professional	26	$69.26	$91.67	$101.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.08 / $239.66 / $266.29	Professional	TC	$181.08	$239.66	$266.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.38 / $158.90 / $255.23	Professional		$62.38	$158.90	$255.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.63 / $491.29 / $728.85	Professional		$255.63	$491.29	$728.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $92.00 / $139.19	Professional	26	$61.72	$92.00	$139.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.79 / $354.42 / $616.40	Professional	TC	$171.79	$354.42	$616.40
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $385.08 / $385.08 / $698.74	Professional		$385.08	$385.08	$698.74
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $60.38 / $118.31 / $134.77	Professional	26	$60.38	$118.31	$134.77
United Facility/Professional Professional Modifier Low / Median / High Price $248.57 / $458.99 / $581.70	Professional		$248.57	$458.99	$581.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.04 / $82.72 / $127.09	Professional	26	$62.04	$82.72	$127.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.30 / $308.57 / $446.90	Professional	TC	$177.30	$308.57	$446.90