Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.27 / $371.81 / $512.60	Facility		$96.27	$371.81	$512.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.22 / $35.60 / $43.09	Facility	26	$34.22	$35.60	$43.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $111.12 / $175.00	Professional		$75.17	$111.12	$175.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $35.21 / $40.34	Professional	26	$22.70	$35.21	$40.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $75.92 / $75.92	Professional	TC	$49.89	$75.92	$75.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $142.40 / $167.57	Professional		$81.00	$142.40	$167.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.68 / $41.68 / $43.44	Professional	26	$41.68	$41.68	$43.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.65 / $75.65 / $82.31	Facility		$75.65	$75.65	$82.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $136.53 / $151.69	Professional		$118.33	$136.53	$151.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.75 / $40.10 / $44.55	Professional	26	$34.75	$40.10	$44.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.58 / $96.44 / $107.15	Professional	TC	$83.58	$96.44	$107.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.34 / $109.80 / $147.15	Facility		$37.34	$109.80	$147.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $96.64 / $169.71	Professional		$31.97	$96.64	$169.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $124.89 / $193.63	Professional		$98.76	$124.89	$193.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.37 / $38.07 / $51.92	Professional	26	$29.37	$38.07	$51.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.56 / $90.22 / $139.88	Professional	TC	$62.56	$90.22	$139.88
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $93.15 / $163.76 / $192.71	Professional		$93.15	$163.76	$192.71
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $47.93 / $49.96	Professional	26	$47.93	$47.93	$49.96
United Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $111.02 / $179.67	Professional		$74.23	$111.02	$179.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.80 / $29.44 / $49.87	Professional	26	$24.80	$29.44	$49.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.59 / $80.43 / $146.81	Professional	TC	$46.59	$80.43	$146.81