Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $83.18 / $109.65	Facility	26	$70.79	$83.18	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $281.84	Professional		$128.82	$169.82	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $177.83	Professional	26	$52.48	$72.44	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $87.10 / $218.78	Professional	TC	$66.07	$87.10	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $95.50 / $123.03	Professional	26	$52.48	$95.50	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $169.82 / $218.78	Professional		$147.91	$169.82	$218.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $112.20	Professional	26	$75.86	$87.10	$112.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $83.18 / $104.71	Professional	TC	$72.44	$83.18	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $158.49	Professional		$60.26	$91.20	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $380.19	Professional		$128.82	$229.09	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $141.25	Professional	26	$57.54	$85.11	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $123.03 / $302.00	Professional	TC	$61.66	$123.03	$302.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $144.54	Professional	26	$85.11	$125.89	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $331.13	Professional		$131.83	$169.82	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $128.82	Professional	26	$57.54	$75.86	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $95.50 / $229.09	Professional	TC	$63.10	$95.50	$229.09