Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $131.83 / $131.83	Facility	26	$120.23	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $229.09 / $478.63	Professional		$162.18	$229.09	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $141.25	Professional	26	$52.48	$81.28	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $151.36 / $338.84	Professional	TC	$112.20	$151.36	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $69.18 / $138.04	Professional	26	$57.54	$69.18	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $275.42 / $346.74	Professional		$239.88	$275.42	$346.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $91.20 / $117.49	Professional	26	$79.43	$91.20	$117.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $181.97 / $234.42	Professional	TC	$158.49	$181.97	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $501.19	Professional		$218.78	$316.23	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $109.65 / $173.78	Professional	26	$74.13	$109.65	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $331.13	Professional	TC	$144.54	$213.80	$331.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	26	$158.49	$158.49	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $407.38 / $1,096.48	Professional		$223.87	$407.38	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $85.11 / $151.36	Professional	26	$70.79	$85.11	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $257.04 / $954.99	Professional	TC	$151.36	$257.04	$954.99