Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.47 / $132.52 / $267.83	Facility	26	$110.47	$132.52	$267.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.68 / $421.50 / $547.46	Professional		$306.68	$421.50	$547.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.00 / $132.52 / $383.43	Professional	26	$81.00	$132.52	$383.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.22 / $290.76 / $394.23	Professional	TC	$230.22	$290.76	$394.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $458.77 / $472.61 / $506.53	Professional		$458.77	$472.61	$506.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $139.24 / $158.60	Professional	26	$67.61	$139.24	$158.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $275.33 / $337.01 / $337.01	Professional	TC	$275.33	$337.01	$337.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.39 / $404.19 / $449.10	Professional		$305.39	$404.19	$449.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.85 / $124.21 / $138.01	Professional	26	$93.85	$124.21	$138.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $211.54 / $279.98 / $311.08	Professional	TC	$211.54	$279.98	$311.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.43 / $215.66 / $346.21	Professional		$84.43	$215.66	$346.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.27 / $442.44 / $625.02	Professional		$276.27	$442.44	$625.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.42 / $124.47 / $185.84	Professional	26	$82.42	$124.47	$185.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.91 / $309.08 / $440.71	Professional	TC	$192.91	$309.08	$440.71
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $527.59 / $543.50 / $593.50	Professional		$527.59	$543.50	$593.50
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $110.02 / $165.03 / $202.40	Professional	26	$110.02	$165.03	$202.40
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $365.38 / $380.18 / $387.56	Professional	TC	$365.38	$380.18	$387.56
United Facility/Professional Professional Modifier Low / Median / High Price $301.60 / $381.47 / $585.36	Professional		$301.60	$381.47	$585.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.32 / $102.35 / $168.25	Professional	26	$83.32	$102.35	$168.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $207.86 / $259.94 / $414.75	Professional	TC	$207.86	$259.94	$414.75