Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.59 / $83.09 / $109.99	Facility	26	$71.59	$83.09	$109.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.21 / $171.80 / $289.82	Professional		$147.21	$171.80	$289.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $83.09 / $151.19	Professional	26	$52.54	$83.09	$151.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.34 / $99.40 / $212.80	Professional	TC	$88.34	$99.40	$212.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.86 / $193.86 / $193.86	Professional		$193.86	$193.86	$193.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.74 / $109.36 / $127.06	Professional	26	$59.74	$109.36	$127.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $195.35 / $217.06	Professional		$162.80	$195.35	$217.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.64 / $100.37 / $111.52	Professional	26	$83.64	$100.37	$111.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.16 / $94.99 / $105.54	Professional	TC	$79.16	$94.99	$105.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $80.63 / $151.51	Professional		$56.12	$80.63	$151.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.58 / $214.64 / $352.39	Professional		$128.58	$214.64	$352.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.75 / $85.22 / $136.06	Professional	26	$58.75	$85.22	$136.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.09 / $115.63 / $294.89	Professional	TC	$68.09	$115.63	$294.89
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $222.94 / $222.94 / $222.94	Professional		$222.94	$222.94	$222.94
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $68.70 / $125.76 / $146.12	Professional	26	$68.70	$125.76	$146.12
United Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $207.90 / $354.43	Professional		$138.37	$207.90	$354.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.82 / $85.97 / $137.38	Professional	26	$57.82	$85.97	$137.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $103.23 / $219.24	Professional	TC	$67.81	$103.23	$219.24