Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.51 / $35.82 / $41.22	Facility	26	$27.51	$35.82	$41.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $130.38 / $206.56	Professional		$82.81	$130.38	$206.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $33.65 / $61.20	Professional	26	$22.87	$33.65	$61.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $97.25 / $141.72	Professional	TC	$59.92	$97.25	$141.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $180.83 / $180.83 / $180.83	Professional		$180.83	$180.83	$180.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $41.27 / $46.09	Professional	26	$27.86	$41.27	$46.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.85 / $170.54 / $189.49	Professional		$128.85	$170.54	$189.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $38.63 / $42.92	Professional	26	$29.19	$38.63	$42.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.67 / $131.91 / $146.57	Professional	TC	$99.67	$131.91	$146.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.54 / $94.62 / $137.04	Professional		$24.54	$94.62	$137.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.90 / $124.70 / $218.19	Professional		$85.90	$124.70	$218.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.35 / $36.64 / $49.44	Professional	26	$24.35	$36.64	$49.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.19 / $89.23 / $169.00	Professional	TC	$56.19	$89.23	$169.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $207.95 / $207.95 / $207.95	Professional		$207.95	$207.95	$207.95
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $47.46 / $53.00	Professional	26	$39.90	$47.46	$53.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $130.30 / $232.77	Professional		$81.81	$130.30	$232.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $38.54 / $49.04	Professional	26	$24.87	$38.54	$49.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.42 / $102.89 / $182.84	Professional	TC	$55.42	$102.89	$182.84