Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.00 / $66.72 / $71.76	Facility	26	$53.00	$66.72	$71.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.19 / $195.79 / $709.48	Professional		$126.19	$195.79	$709.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.76 / $64.80 / $257.12	Professional	26	$45.76	$64.80	$257.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.44 / $119.52 / $452.37	Professional	TC	$80.44	$119.52	$452.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.99 / $177.99 / $206.80	Professional		$177.99	$177.99	$206.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.51 / $71.34 / $74.51	Professional	26	$57.51	$71.34	$74.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $107.72 / $107.72 / $107.72	Professional	TC	$107.72	$107.72	$107.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.52 / $154.22 / $171.35	Professional		$116.52	$154.22	$171.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.76 / $60.56 / $67.29	Professional	26	$45.76	$60.56	$67.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.76 / $93.65 / $104.06	Professional	TC	$70.76	$93.65	$104.06
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $204.69 / $204.69 / $237.82	Professional		$204.69	$204.69	$237.82
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $66.14 / $82.04 / $95.32	Professional	26	$66.14	$82.04	$95.32
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $123.88 / $123.88 / $123.88	Professional	TC	$123.88	$123.88	$123.88
United Facility/Professional Professional Modifier Low / Median / High Price $108.32 / $176.24 / $216.80	Professional		$108.32	$176.24	$216.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.19 / $50.19 / $82.32	Professional	26	$40.19	$50.19	$82.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.13 / $119.61 / $148.82	Professional	TC	$68.13	$119.61	$148.82