Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.29 / $283.50 / $1,394.70	Facility		$98.29	$283.50	$1,394.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.50 / $95.02 / $126.69	Facility	26	$70.50	$95.02	$126.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.51 / $211.53 / $424.02	Professional		$132.51	$211.53	$424.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $75.90 / $117.54	Professional	26	$48.86	$75.90	$117.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $59.13 / $102.75 / $264.91	Professional	52	$59.13	$102.75	$264.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.45 / $162.66 / $348.12	Professional	TC	$59.45	$162.66	$348.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.13 / $84.67 / $84.67	Professional	26	$79.13	$84.67	$84.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,660.52 / $2,660.52 / $2,894.65	Facility		$2,660.52	$2,660.52	$2,894.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.59 / $215.19 / $239.10	Professional		$162.59	$215.19	$239.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.19 / $115.40 / $128.22	Professional	26	$87.19	$115.40	$128.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.40 / $99.79 / $110.88	Professional	TC	$75.40	$99.79	$110.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.96 / $102.42 / $186.48	Facility		$59.96	$102.42	$186.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $91.85 / $166.80	Professional		$59.96	$91.85	$166.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.77 / $2,360.64 / $4,616.56	Facility		$198.77	$2,360.64	$4,616.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.29 / $274.64 / $820.98	Professional		$142.29	$274.64	$820.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.83 / $89.46 / $156.35	Professional	26	$57.83	$89.46	$156.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.54 / $134.91 / $569.17	Professional	TC	$71.54	$134.91	$569.17
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $79.56 / $97.37 / $150.72	Professional	26	$79.56	$97.37	$150.72
United Facility/Professional Professional Modifier Low / Median / High Price $157.62 / $230.40 / $613.83	Professional		$157.62	$230.40	$613.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.94 / $91.07 / $157.88	Professional	26	$56.94	$91.07	$157.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.16 / $123.35 / $482.45	Professional	TC	$73.16	$123.35	$482.45