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 / $77.73	Facility	26	$61.44	$67.19	$77.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.66 / $169.93 / $290.70	Professional		$113.66	$169.93	$290.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $61.44 / $87.89	Professional	26	$40.67	$61.44	$87.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.98 / $106.43 / $131.18	Professional	TC	$72.98	$106.43	$131.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $185.32 / $209.04 / $232.45	Professional		$185.32	$209.04	$232.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $74.84 / $83.47	Professional	26	$35.07	$74.84	$83.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $119.60 / $133.50 / $141.85	Professional	TC	$119.60	$133.50	$141.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.41 / $179.23 / $199.14	Professional		$135.41	$179.23	$199.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.39 / $68.02 / $75.58	Professional	26	$51.39	$68.02	$75.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.02 / $111.20 / $123.56	Professional	TC	$84.02	$111.20	$123.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.29 / $85.32 / $166.45	Professional		$46.29	$85.32	$166.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.70 / $186.08 / $250.37	Professional		$111.70	$186.08	$250.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $68.62 / $92.66	Professional	26	$40.24	$68.62	$92.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.45 / $116.90 / $157.24	Professional	TC	$71.45	$116.90	$157.24
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $239.40 / $267.32	Professional		$170.28	$239.40	$267.32
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $61.54 / $86.87 / $100.00	Professional	26	$61.54	$86.87	$100.00
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $137.54 / $149.82 / $163.13	Professional	TC	$137.54	$149.82	$163.13
United Facility/Professional Professional Modifier Low / Median / High Price $126.76 / $152.11 / $239.10	Professional		$126.76	$152.11	$239.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.81 / $55.36 / $90.81	Professional	26	$45.81	$55.36	$90.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.73 / $108.50 / $148.29	Professional	TC	$79.73	$108.50	$148.29