Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.42 / $46.41 / $62.87	Facility	26	$43.42	$46.41	$62.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $148.63 / $209.97	Professional		$109.14	$148.63	$209.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $43.42 / $73.44	Professional	26	$29.91	$43.42	$73.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $103.75 / $141.50	Professional	TC	$79.23	$103.75	$141.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $204.96	Professional		$204.96	$204.96	$204.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.92 / $55.52 / $77.75	Professional	26	$38.92	$55.52	$77.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $183.14 / $203.49	Professional		$138.37	$183.14	$203.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.64 / $49.82 / $55.36	Professional	26	$37.64	$49.82	$55.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.73 / $133.32 / $148.13	Professional	TC	$100.73	$133.32	$148.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $92.33 / $154.43	Professional		$41.39	$92.33	$154.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $156.96 / $249.50	Professional		$109.50	$156.96	$249.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.10 / $48.21 / $82.85	Professional	26	$36.10	$48.21	$82.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $109.98 / $170.79	Professional	TC	$69.95	$109.98	$170.79
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $235.70 / $235.70 / $235.70	Professional		$235.70	$235.70	$235.70
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $60.10 / $63.85 / $89.41	Professional	26	$60.10	$63.85	$89.41
United Facility/Professional Professional Modifier Low / Median / High Price $110.20 / $137.91 / $242.64	Professional		$110.20	$137.91	$242.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $47.58 / $83.67	Professional	26	$34.54	$47.58	$83.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.66 / $95.56 / $164.81	Professional	TC	$75.66	$95.56	$164.81