Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.70 / $197.79 / $211.91	Facility	26	$164.70	$197.79	$211.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $408.44 / $610.94 / $1,111.50	Professional		$408.44	$610.94	$1,111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.84 / $193.99 / $386.40	Professional	26	$125.84	$193.99	$386.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $282.61 / $408.11 / $498.73	Professional	TC	$282.61	$408.11	$498.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $619.71 / $619.71 / $619.71	Professional		$619.71	$619.71	$619.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $197.11 / $201.06 / $203.24	Professional	26	$197.11	$201.06	$203.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $435.96 / $577.01 / $641.12	Professional		$435.96	$577.01	$641.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $140.01 / $185.31 / $205.90	Professional	26	$140.01	$185.31	$205.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.95 / $391.70 / $435.22	Professional	TC	$295.95	$391.70	$435.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.52 / $239.17 / $414.50	Professional		$119.52	$239.17	$414.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.57 / $619.33 / $1,041.50	Professional		$368.57	$619.33	$1,041.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.53 / $175.08 / $263.33	Professional	26	$116.53	$175.08	$263.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $247.87 / $422.03 / $788.25	Professional	TC	$247.87	$422.03	$788.25
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $712.67 / $712.67 / $712.67	Professional		$712.67	$712.67	$712.67
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $226.68 / $231.22 / $258.20	Professional	26	$226.68	$231.22	$258.20
United Facility/Professional Professional Modifier Low / Median / High Price $397.24 / $594.51 / $838.86	Professional		$397.24	$594.51	$838.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.81 / $148.86 / $241.22	Professional	26	$117.81	$148.86	$241.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.70 / $444.97 / $647.40	Professional	TC	$260.70	$444.97	$647.40