Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $162.18 / $177.83	Facility	26	$112.20	$162.18	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $933.25	Professional		$251.19	$467.74	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $154.88 / $338.84	Professional	26	$85.11	$154.88	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $645.65	Professional	TC	$257.04	$338.84	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $575.44 / $660.69	Professional		$281.84	$575.44	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $162.18 / $186.21	Professional	26	$75.86	$162.18	$186.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $218.78 / $416.87	Professional	TC	$218.78	$218.78	$416.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $645.65	Professional		$436.52	$501.19	$645.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $125.89 / $162.18	Professional	26	$109.65	$125.89	$162.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $380.19 / $478.63	Professional	TC	$331.13	$380.19	$478.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $257.04 / $478.63	Professional		$100.00	$257.04	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $776.25 / $1,548.82	Professional		$389.05	$776.25	$1,548.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $147.91 / $229.09	Professional	26	$97.72	$147.91	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $616.60 / $1,380.38	Professional	TC	$281.84	$616.60	$1,380.38
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $676.08	Professional		$660.69	$660.69	$676.08
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $194.98 / $213.80	Professional	26	$87.10	$194.98	$213.80
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $478.63 / $478.63	Professional	TC	$478.63	$478.63	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $676.08 / $1,380.38	Professional		$398.11	$676.08	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $120.23 / $199.53	Professional	26	$95.50	$120.23	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $489.78 / $1,096.48	Professional	TC	$302.00	$489.78	$1,096.48