Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.89 / $50.64 / $56.52	Facility	26	$42.89	$50.64	$56.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.38 / $118.48 / $187.94	Professional		$112.38	$118.48	$187.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $35.86 / $62.39	Professional	26	$27.74	$35.86	$62.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.67 / $87.95 / $130.61	Professional	TC	$72.67	$87.95	$130.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.60 / $145.13 / $305.38	Professional		$136.60	$145.13	$305.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $49.16 / $59.51	Professional	26	$29.71	$49.16	$59.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.93 / $162.69 / $180.78	Professional		$122.93	$162.69	$180.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.59 / $45.78 / $50.87	Professional	26	$34.59	$45.78	$50.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.34 / $116.92 / $129.91	Professional	TC	$88.34	$116.92	$129.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $160.86 / $239.53	Professional		$31.68	$160.86	$239.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $169.48 / $280.95	Professional		$115.01	$169.48	$280.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $46.28 / $62.84	Professional	26	$27.91	$46.28	$62.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.00 / $118.06 / $222.15	Professional	TC	$70.00	$118.06	$222.15
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $157.09 / $166.91 / $351.19	Professional		$157.09	$166.91	$351.19
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $56.53 / $68.44	Professional	26	$40.04	$56.53	$68.44
United Facility/Professional Professional Modifier Low / Median / High Price $119.41 / $159.88 / $305.60	Professional		$119.41	$159.88	$305.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.15 / $38.35 / $61.72	Professional	26	$31.15	$38.35	$61.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.16 / $119.31 / $241.05	Professional	TC	$86.16	$119.31	$241.05