Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.18 / $167.89 / $181.91	Facility	26	$114.18	$167.89	$181.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $462.16 / $582.16 / $937.54	Professional		$462.16	$582.16	$937.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.22 / $172.40 / $386.40	Professional	26	$99.22	$172.40	$386.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $276.43 / $414.64 / $478.33	Professional	TC	$276.43	$414.64	$478.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $293.43 / $514.17 / $578.41	Professional		$293.43	$514.17	$578.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.73 / $167.90 / $187.03	Professional	26	$76.73	$167.90	$187.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $344.48 / $358.42 / $603.66	Professional	TC	$344.48	$358.42	$603.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.64 / $505.12 / $561.24	Professional		$381.64	$505.12	$561.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.91 / $149.44 / $166.05	Professional	26	$112.91	$149.44	$166.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.73 / $355.67 / $395.19	Professional	TC	$268.73	$355.67	$395.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $101.81 / $233.94 / $387.53	Professional		$101.81	$233.94	$387.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.34 / $724.54 / $1,519.76	Professional		$382.34	$724.54	$1,519.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.21 / $149.74 / $223.82	Professional	26	$103.21	$149.74	$223.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.42 / $521.79 / $1,370.80	Professional	TC	$274.42	$521.79	$1,370.80
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $591.30 / $597.16 / $665.18	Professional		$591.30	$597.16	$665.18
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $136.56 / $204.84 / $219.94	Professional	26	$136.56	$204.84	$219.94
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $396.15 / $412.18 / $720.42	Professional	TC	$396.15	$412.18	$720.42
United Facility/Professional Professional Modifier Low / Median / High Price $377.48 / $653.73 / $1,243.72	Professional		$377.48	$653.73	$1,243.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.57 / $130.79 / $205.39	Professional	26	$102.57	$130.79	$205.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $262.63 / $448.34 / $951.49	Professional	TC	$262.63	$448.34	$951.49