Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.44 / $122.27 / $134.87	Facility	26	$101.44	$122.27	$134.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.85 / $532.00 / $661.93	Professional		$327.85	$532.00	$661.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.67 / $134.87 / $161.00	Professional	26	$97.67	$134.87	$161.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $404.73 / $524.07	Professional	TC	$335.00	$404.73	$524.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.30 / $467.97 / $467.97	Professional		$269.30	$467.97	$467.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.40 / $123.99 / $141.22	Professional	26	$85.40	$123.99	$141.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $355.10 / $469.98 / $522.20	Professional		$355.10	$469.98	$522.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.71 / $110.79 / $123.10	Professional	26	$83.71	$110.79	$123.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $271.39 / $359.19 / $399.10	Professional	TC	$271.39	$359.19	$399.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.19 / $235.26 / $357.50	Professional		$75.19	$235.26	$357.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.47 / $574.12 / $837.89	Professional		$334.47	$574.12	$837.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $111.19 / $168.41	Professional	26	$74.45	$111.19	$168.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.48 / $444.01 / $739.74	Professional	TC	$257.48	$444.01	$739.74
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $538.16 / $538.16 / $538.16	Professional		$538.16	$538.16	$538.16
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $139.79 / $145.46 / $162.41	Professional	26	$139.79	$145.46	$162.41
United Facility/Professional Professional Modifier Low / Median / High Price $335.62 / $527.92 / $710.32	Professional		$335.62	$527.92	$710.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.36 / $94.88 / $153.43	Professional	26	$75.36	$94.88	$153.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $259.82 / $440.77 / $576.70	Professional	TC	$259.82	$440.77	$576.70