Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $199.53 / $213.80	Facility	26	$165.96	$199.53	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $891.25	Professional		$354.81	$478.63	$891.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $186.21 / $398.11	Professional	26	$100.00	$186.21	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $575.44	Professional	TC	$223.87	$338.84	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $199.53 / $234.42	Professional	26	$93.33	$199.53	$234.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $645.65	Professional		$436.52	$501.19	$645.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $162.18 / $204.17	Professional	26	$141.25	$162.18	$204.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $338.84 / $436.52	Professional	TC	$295.12	$338.84	$436.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $275.42 / $524.81	Professional		$120.23	$275.42	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $676.08 / $1,047.13	Professional		$371.54	$676.08	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $173.78 / $275.42	Professional	26	$117.49	$173.78	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $512.86 / $831.76	Professional	TC	$239.88	$512.86	$831.76
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $245.47 / $524.81	Professional	26	$229.09	$245.47	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $588.84 / $870.96	Professional		$371.54	$588.84	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $141.25 / $245.47	Professional	26	$112.20	$141.25	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $660.69	Professional	TC	$257.04	$407.38	$660.69