Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $87.10 / $91.20	Facility	26	$74.13	$87.10	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $346.74	Professional		$138.04	$194.98	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $131.83	Professional	26	$51.29	$67.61	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $229.09	Professional	TC	$81.28	$117.49	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $208.93 / $234.42	Professional		$102.33	$208.93	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $87.10 / $104.71	Professional	26	$42.66	$87.10	$104.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $120.23 / $177.83	Professional	TC	$120.23	$120.23	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $213.80	Professional		$144.54	$165.96	$213.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $91.20	Professional	26	$61.66	$70.79	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $95.50 / $123.03	Professional	TC	$83.18	$95.50	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $100.00 / $204.17	Professional		$54.95	$100.00	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $275.42 / $436.52	Professional		$131.83	$275.42	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $134.90	Professional	26	$54.95	$83.18	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $169.82 / $316.23	Professional	TC	$77.62	$169.82	$316.23
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $269.15	Professional		$239.88	$239.88	$269.15
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $107.15 / $131.83	Professional	26	$70.79	$107.15	$131.83
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $204.17	Professional	TC	$138.04	$138.04	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $223.87 / $407.38	Professional		$131.83	$223.87	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $109.65	Professional	26	$52.48	$66.07	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $123.03 / $275.42	Professional	TC	$79.43	$123.03	$275.42