Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.43 / $109.38 / $120.99	Facility	26	$75.43	$109.38	$120.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.87 / $436.73 / $620.15	Professional		$237.87	$436.73	$620.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.37 / $128.00 / $327.58	Professional	26	$87.37	$128.00	$327.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $315.74 / $441.00	Professional	TC	$187.50	$315.74	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.72 / $299.02 / $299.02	Professional		$170.72	$299.02	$299.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $113.15 / $126.36	Professional	26	$51.45	$113.15	$126.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $187.31 / $187.31 / $187.31	Professional	TC	$187.31	$187.31	$187.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.97 / $309.67 / $344.08	Professional		$233.97	$309.67	$344.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.09 / $99.40 / $110.44	Professional	26	$75.09	$99.40	$110.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.88 / $210.28 / $233.64	Professional	TC	$158.88	$210.28	$233.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.26 / $127.26 / $224.83	Professional		$67.26	$127.26	$224.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.92 / $459.46 / $774.61	Professional		$238.92	$459.46	$774.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.50 / $100.67 / $151.09	Professional	26	$66.50	$100.67	$151.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.24 / $296.14 / $620.00	Professional	TC	$162.24	$296.14	$620.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $343.87 / $343.87 / $343.87	Professional		$343.87	$343.87	$343.87
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $36.33 / $130.12 / $145.31	Professional	26	$36.33	$130.12	$145.31
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $215.41 / $215.41 / $215.41	Professional	TC	$215.41	$215.41	$215.41
United Facility/Professional Professional Modifier Low / Median / High Price $213.02 / $376.52 / $590.08	Professional		$213.02	$376.52	$590.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $90.08 / $144.47	Professional	26	$66.20	$90.08	$144.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.05 / $262.56 / $429.02	Professional	TC	$146.05	$262.56	$429.02