Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.93 / $223.25 / $637.24	Facility		$93.93	$223.25	$637.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.51 / $39.86 / $109.65	Facility	26	$30.51	$39.86	$109.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $71.84 / $110.98 / $468.26	Facility	TC	$71.84	$110.98	$468.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $109.13 / $282.20	Professional		$73.63	$109.13	$282.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $37.27 / $117.17	Professional	26	$24.19	$37.27	$117.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.43 / $71.84 / $89.78	Professional	TC	$49.43	$71.84	$89.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $128.97 / $146.55	Professional		$74.37	$128.97	$146.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.74 / $44.87 / $51.11	Professional	26	$20.74	$44.87	$51.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $84.99 / $96.21 / $96.21	Professional	TC	$84.99	$96.21	$96.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $107.60 / $117.07	Facility		$107.60	$107.60	$117.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.22 / $115.43 / $128.26	Professional		$87.22	$115.43	$128.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.03 / $39.74 / $44.16	Professional	26	$30.03	$39.74	$44.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.19 / $75.69 / $84.10	Professional	TC	$57.19	$75.69	$84.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.40 / $63.18 / $102.80	Facility		$28.40	$63.18	$102.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $57.92 / $107.37	Professional		$27.21	$57.92	$107.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.69 / $121.80 / $179.19	Facility		$73.69	$121.80	$179.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $119.99 / $161.80	Professional		$73.84	$119.99	$161.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.53 / $40.24 / $54.80	Professional	26	$23.53	$40.24	$54.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.29 / $79.30 / $107.64	Professional	TC	$47.29	$79.30	$107.64
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $148.33 / $154.34 / $165.40	Professional		$148.33	$154.34	$165.40
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.46 / $53.11 / $67.45	Professional	26	$29.46	$53.11	$67.45
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $97.74 / $102.82 / $110.64	Professional	TC	$97.74	$102.82	$110.64
United Facility/Professional Professional Modifier Low / Median / High Price $83.48 / $104.26 / $163.38	Professional		$83.48	$104.26	$163.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $32.95 / $53.51	Professional	26	$26.96	$32.95	$53.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.82 / $69.86 / $101.52	Professional	TC	$53.82	$69.86	$101.52