Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.91 / $86.57 / $96.03	Facility	26	$73.91	$86.57	$96.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.03 / $223.90 / $316.25	Professional		$167.03	$223.90	$316.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.73 / $98.00	Professional	26	$51.29	$74.73	$98.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.62 / $143.43 / $234.88	Professional	TC	$95.62	$143.43	$234.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $88.73 / $92.92	Professional	26	$41.27	$88.73	$92.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.74 / $112.74 / $177.39	Professional	TC	$112.74	$112.74	$177.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.66 / $191.47 / $212.74	Professional		$144.66	$191.47	$212.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $81.14 / $90.16	Professional	26	$61.31	$81.14	$90.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.35 / $110.32 / $122.58	Professional	TC	$83.35	$110.32	$122.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.88 / $86.08 / $157.40	Professional		$54.88	$86.08	$157.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.90 / $255.18 / $435.72	Professional		$132.90	$255.18	$435.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.49 / $82.24 / $122.93	Professional	26	$54.49	$82.24	$122.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.27 / $147.55 / $314.41	Professional	TC	$78.27	$147.55	$314.41
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $100.57 / $104.09 / $132.25	Professional	26	$100.57	$104.09	$132.25
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $137.03 / $137.03 / $204.00	Professional	TC	$137.03	$137.03	$204.00
United Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $242.94 / $330.14	Professional		$139.44	$242.94	$330.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.89 / $86.58 / $111.28	Professional	26	$54.89	$86.58	$111.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.53 / $138.38 / $262.10	Professional	TC	$81.53	$138.38	$262.10