Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.94 / $171.73 / $182.00	Facility	26	$123.94	$171.73	$182.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $303.74 / $409.55 / $927.71	Professional		$303.74	$409.55	$927.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $148.12 / $259.01	Professional	26	$100.31	$148.12	$259.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.56 / $276.72 / $373.84	Professional	TC	$213.56	$276.72	$373.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $509.09 / $509.09 / $700.00	Professional		$509.09	$509.09	$700.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $88.43 / $184.73 / $207.61	Professional	26	$88.43	$184.73	$207.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $604.11 / $604.11 / $604.11	Professional	TC	$604.11	$604.11	$604.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $375.67 / $497.21 / $552.45	Professional		$375.67	$497.21	$552.45
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $121.61 / $160.96 / $178.84	Professional	26	$121.61	$160.96	$178.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $254.05 / $336.25 / $373.61	Professional	TC	$254.05	$336.25	$373.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $110.52 / $211.13 / $371.58	Professional		$110.52	$211.13	$371.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $330.78 / $566.11 / $892.80	Professional		$330.78	$566.11	$892.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.73 / $161.54 / $243.07	Professional	26	$107.73	$161.54	$243.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.66 / $387.84 / $694.87	Professional	TC	$226.66	$387.84	$694.87
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $230.00 / $585.45 / $805.00	Professional		$230.00	$585.45	$805.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $106.23 / $212.44 / $238.75	Professional	26	$106.23	$212.44	$238.75
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $509.45 / $509.45 / $509.45	Professional	TC	$509.45	$509.45	$509.45
United Facility/Professional Professional Modifier Low / Median / High Price $333.45 / $578.29 / $784.53	Professional		$333.45	$578.29	$784.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.48 / $145.08 / $223.00	Professional	26	$108.48	$145.08	$223.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.31 / $319.89 / $585.49	Professional	TC	$220.31	$319.89	$585.49