Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.44 / $67.19 / $77.42	Facility	26	$61.44	$67.19	$77.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.04 / $148.12 / $236.51	Professional		$99.04	$148.12	$236.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $61.44 / $86.54	Professional	26	$40.67	$61.44	$86.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.37 / $84.76 / $106.51	Professional	TC	$58.37	$84.76	$106.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $174.76 / $203.04	Professional		$129.94	$174.76	$203.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.85 / $74.37 / $81.06	Professional	26	$34.85	$74.37	$81.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.86 / $106.59 / $113.25	Professional	TC	$95.86	$106.59	$113.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.63 / $157.01 / $174.45	Professional		$118.63	$157.01	$174.45
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.17 / $67.73 / $75.25	Professional	26	$51.17	$67.73	$75.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $89.28 / $99.20	Professional	TC	$67.45	$89.28	$99.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $68.41 / $135.47	Professional		$46.00	$68.41	$135.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $158.69 / $218.63	Professional		$97.04	$158.69	$218.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $67.27 / $92.07	Professional	26	$39.97	$67.27	$92.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.00 / $94.12 / $126.56	Professional	TC	$56.00	$94.12	$126.56
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $93.54 / $200.97 / $233.50	Professional		$93.54	$200.97	$233.50
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $61.54 / $86.87 / $93.23	Professional	26	$61.54	$86.87	$93.23
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $90.45 / $115.45 / $130.24	Professional	TC	$90.45	$115.45	$130.24
United Facility/Professional Professional Modifier Low / Median / High Price $108.32 / $136.91 / $211.97	Professional		$108.32	$136.91	$211.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.62 / $57.77 / $91.60	Professional	26	$45.62	$57.77	$91.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.05 / $84.08 / $127.80	Professional	TC	$64.05	$84.08	$127.80