Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.86 / $46.38 / $60.71	Facility	26	$41.86	$46.38	$60.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $123.53 / $151.03	Professional		$101.04	$123.53	$151.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $43.83 / $92.87	Professional	26	$29.91	$43.83	$92.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.66 / $87.26 / $101.23	Professional	TC	$68.66	$87.26	$101.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $179.52 / $179.52 / $179.52	Professional		$179.52	$179.52	$179.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $54.97 / $70.13	Professional	26	$28.11	$54.97	$70.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.62 / $164.94 / $183.27	Professional		$124.62	$164.94	$183.27
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $50.30 / $55.89	Professional	26	$38.01	$50.30	$55.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.62 / $114.64 / $127.38	Professional	TC	$86.62	$114.64	$127.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $80.91 / $136.59	Professional		$37.33	$80.91	$136.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.19 / $139.88 / $216.86	Professional		$100.19	$139.88	$216.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.86 / $48.07 / $74.72	Professional	26	$33.86	$48.07	$74.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.88 / $92.97 / $146.91	Professional	TC	$60.88	$92.97	$146.91
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $206.45 / $206.45 / $206.45	Professional		$206.45	$206.45	$206.45
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $42.15 / $69.41 / $80.65	Professional	26	$42.15	$69.41	$80.65
United Facility/Professional Professional Modifier Low / Median / High Price $97.88 / $124.69 / $219.19	Professional		$97.88	$124.69	$219.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $46.94 / $74.70	Professional	26	$34.54	$46.94	$74.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.34 / $82.64 / $143.91	Professional	TC	$63.34	$82.64	$143.91