Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $120.23 / $134.90	Facility	26	$85.11	$120.23	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $416.87 / $660.69	Professional		$223.87	$416.87	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $128.82 / $194.98	Professional	26	$75.86	$128.82	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $338.84 / $537.03	Professional	TC	$213.80	$338.84	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $120.23 / $141.25	Professional	26	$57.54	$120.23	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	TC	$181.97	$181.97	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $524.81	Professional		$354.81	$407.38	$524.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $95.50 / $123.03	Professional	26	$83.18	$95.50	$123.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $398.11	Professional	TC	$269.15	$309.03	$398.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $213.80 / $389.05	Professional		$75.86	$213.80	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $588.84 / $870.96	Professional		$316.23	$588.84	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $112.20 / $173.78	Professional	26	$74.13	$112.20	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $467.74 / $741.31	Professional	TC	$239.88	$467.74	$741.31
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Professional		$537.03	$537.03	$537.03
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $147.91 / $165.96	Professional	26	$97.72	$147.91	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $812.83	Professional		$323.59	$524.81	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $91.20 / $151.36	Professional	26	$72.44	$91.20	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $407.38 / $660.69	Professional	TC	$251.19	$407.38	$660.69