Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.08 / $92.27 / $102.80	Facility	26	$79.08	$92.27	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.57 / $339.97 / $485.65	Professional		$263.57	$339.97	$485.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.00 / $84.31 / $199.20	Professional	26	$58.00	$84.31	$199.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.66 / $262.49 / $408.74	Professional	TC	$201.66	$262.49	$408.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $349.72 / $349.72 / $349.72	Professional		$349.72	$349.72	$349.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.73 / $96.84 / $100.51	Professional	26	$65.73	$96.84	$100.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.86 / $301.58 / $335.09	Professional		$227.86	$301.58	$335.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.33 / $86.47 / $96.08	Professional	26	$65.33	$86.47	$96.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.53 / $215.11 / $239.01	Professional	TC	$162.53	$215.11	$239.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.72 / $170.65 / $264.29	Professional		$58.72	$170.65	$264.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.29 / $363.85 / $531.29	Professional		$204.29	$363.85	$531.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $87.65 / $131.72	Professional	26	$58.24	$87.65	$131.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.05 / $268.14 / $395.00	Professional	TC	$146.05	$268.14	$395.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $402.18 / $402.18 / $402.18	Professional		$402.18	$402.18	$402.18
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $76.29 / $113.60 / $126.86	Professional	26	$76.29	$113.60	$126.86
United Facility/Professional Professional Modifier Low / Median / High Price $226.06 / $337.61 / $481.56	Professional		$226.06	$337.61	$481.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.11 / $91.87 / $117.58	Professional	26	$58.11	$91.87	$117.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.27 / $263.26 / $335.19	Professional	TC	$167.27	$263.26	$335.19