Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.06 / $145.36 / $167.16	Facility	26	$104.06	$145.36	$167.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.12 / $473.38 / $617.61	Professional		$347.12	$473.38	$617.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.53 / $124.95 / $173.44	Professional	26	$84.53	$124.95	$173.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.59 / $328.03 / $499.76	Professional	TC	$252.59	$328.03	$499.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $513.54 / $529.04 / $567.01	Professional		$513.54	$529.04	$567.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.98 / $156.10 / $174.31	Professional	26	$70.98	$156.10	$174.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $315.31 / $372.94 / $385.94	Professional	TC	$315.31	$372.94	$385.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.51 / $455.97 / $506.63	Professional		$344.51	$455.97	$506.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.93 / $136.22 / $151.37	Professional	26	$102.93	$136.22	$151.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.58 / $319.73 / $355.26	Professional	TC	$241.58	$319.73	$355.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.79 / $243.41 / $387.65	Professional		$92.79	$243.41	$387.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.20 / $507.59 / $720.86	Professional		$321.20	$507.59	$720.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.59 / $136.74 / $204.32	Professional	26	$90.59	$136.74	$204.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.16 / $367.85 / $528.38	Professional	TC	$229.16	$367.85	$528.38
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $590.58 / $608.40 / $664.37	Professional		$590.58	$608.40	$664.37
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $170.79 / $181.46 / $221.95	Professional	26	$170.79	$181.46	$221.95
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $362.61 / $428.88 / $573.45	Professional	TC	$362.61	$428.88	$573.45
United Facility/Professional Professional Modifier Low / Median / High Price $338.59 / $487.51 / $708.17	Professional		$338.59	$487.51	$708.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.71 / $122.99 / $189.05	Professional	26	$91.71	$122.99	$189.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.80 / $345.96 / $487.87	Professional	TC	$235.80	$345.96	$487.87