Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.89 / $162.26 / $177.43	Facility	26	$111.89	$162.26	$177.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.86 / $598.50 / $1,102.88	Professional		$382.86	$598.50	$1,102.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.26 / $168.98 / $327.58	Professional	26	$105.26	$168.98	$327.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $277.58 / $422.10 / $611.92	Professional	TC	$277.58	$422.10	$611.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $292.37 / $292.37 / $632.88	Professional		$292.37	$292.37	$632.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $161.33 / $167.85 / $183.30	Professional	26	$161.33	$167.85	$183.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $345.93 / $449.00 / $449.00	Professional	TC	$345.93	$449.00	$449.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $503.19 / $559.10	Professional		$380.19	$503.19	$559.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.13 / $145.76 / $161.96	Professional	26	$110.13	$145.76	$161.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $270.06 / $357.43 / $397.14	Professional	TC	$270.06	$357.43	$397.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.78 / $234.92 / $386.24	Professional		$99.78	$234.92	$386.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $378.93 / $738.76 / $1,224.78	Professional		$378.93	$738.76	$1,224.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.00 / $146.99 / $221.04	Professional	26	$98.00	$146.99	$221.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.77 / $527.37 / $1,112.30	Professional	TC	$275.77	$527.37	$1,112.30
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $727.81 / $727.81 / $727.81	Professional		$727.81	$727.81	$727.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $182.69 / $193.03 / $215.56	Professional	26	$182.69	$193.03	$215.56
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $516.35 / $516.35 / $516.35	Professional	TC	$516.35	$516.35	$516.35
United Facility/Professional Professional Modifier Low / Median / High Price $376.45 / $623.42 / $1,109.78	Professional		$376.45	$623.42	$1,109.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.65 / $122.38 / $201.29	Professional	26	$97.65	$122.38	$201.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $258.52 / $450.14 / $918.12	Professional	TC	$258.52	$450.14	$918.12