Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.05 / $101.89 / $113.26	Facility	26	$87.05	$101.89	$113.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.93 / $410.67 / $587.44	Professional		$279.93	$410.67	$587.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $87.59 / $109.89	Professional	26	$60.39	$87.59	$109.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $212.09 / $318.13 / $502.82	Professional	TC	$212.09	$318.13	$502.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $372.14 / $372.14 / $433.95	Professional		$372.14	$372.14	$433.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $108.36 / $121.00	Professional	26	$51.30	$108.36	$121.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $285.00 / $379.22	Professional	TC	$285.00	$285.00	$379.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.19 / $341.72 / $379.69	Professional		$258.19	$341.72	$379.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $95.06 / $105.62	Professional	26	$71.81	$95.06	$105.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.37 / $246.66 / $274.07	Professional	TC	$186.37	$246.66	$274.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.41 / $193.48 / $297.14	Professional		$64.41	$193.48	$297.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.71 / $434.49 / $621.30	Professional		$235.71	$434.49	$621.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.01 / $96.72 / $144.50	Professional	26	$64.01	$96.72	$144.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.69 / $315.22 / $492.59	Professional	TC	$171.69	$315.22	$492.59
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $427.96 / $427.96 / $499.04	Professional		$427.96	$427.96	$499.04
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $83.88 / $125.82 / $139.15	Professional	26	$83.88	$125.82	$139.15
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $316.25 / $316.25 / $436.10	Professional	TC	$316.25	$316.25	$436.10
United Facility/Professional Professional Modifier Low / Median / High Price $249.26 / $431.70 / $583.79	Professional		$249.26	$431.70	$583.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.87 / $86.18 / $129.28	Professional	26	$63.87	$86.18	$129.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.99 / $317.49 / $418.60	Professional	TC	$183.99	$317.49	$418.60