Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.19 / $162.26 / $177.43	Facility	26	$133.19	$162.26	$177.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.98 / $644.07 / $1,111.50	Professional		$403.98	$644.07	$1,111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.00 / $169.14 / $235.45	Professional	26	$110.00	$169.14	$235.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $332.43 / $462.42 / $611.70	Professional	TC	$332.43	$462.42	$611.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $331.50 / $575.59 / $581.34	Professional		$331.50	$575.59	$581.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $158.86 / $168.79 / $187.44	Professional	26	$158.86	$168.79	$187.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $438.16 / $579.91 / $644.35	Professional		$438.16	$579.91	$644.35
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 $328.03 / $434.15 / $482.39	Professional	TC	$328.03	$434.15	$482.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.78 / $281.26 / $439.18	Professional		$99.78	$281.26	$439.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.15 / $680.00 / $1,506.13	Professional		$411.15	$680.00	$1,506.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.29 / $146.87 / $219.33	Professional	26	$98.29	$146.87	$219.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $311.22 / $525.92 / $1,368.55	Professional	TC	$311.22	$525.92	$1,368.55
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $661.93 / $661.93 / $682.35	Professional		$661.93	$661.93	$682.35
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $189.24 / $194.11 / $215.56	Professional	26	$189.24	$194.11	$215.56
United Facility/Professional Professional Modifier Low / Median / High Price $403.31 / $689.26 / $1,234.97	Professional		$403.31	$689.26	$1,234.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $124.91 / $201.29	Professional	26	$100.00	$124.91	$201.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $306.70 / $532.99 / $949.93	Professional	TC	$306.70	$532.99	$949.93