Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $109.65 / $120.23	Facility	26	$75.86	$109.65	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $371.54 / $870.96	Professional		$199.53	$371.54	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $120.23 / $229.09	Professional	26	$66.07	$120.23	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $239.88 / $426.58	Professional	TC	$131.83	$239.88	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $354.81	Professional		$151.36	$173.78	$354.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $107.15 / $123.03	Professional	26	$52.48	$107.15	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $346.74	Professional		$234.42	$269.15	$346.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $109.65	Professional	26	$75.86	$87.10	$109.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $181.97 / $234.42	Professional	TC	$158.49	$181.97	$234.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $154.88 / $288.40	Professional		$67.61	$154.88	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $457.09 / $776.25	Professional		$199.53	$457.09	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $162.18	Professional	26	$66.07	$100.00	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $295.12 / $616.60	Professional	TC	$151.36	$295.12	$616.60
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $128.82 / $144.54	Professional	26	$123.03	$128.82	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $363.08 / $676.08	Professional		$204.17	$363.08	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $138.04	Professional	26	$64.57	$81.28	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $223.87 / $549.54	Professional	TC	$134.90	$223.87	$549.54