Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.41 / $189.84 / $284.76	Facility	26	$173.41	$189.84	$284.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.81 / $532.00 / $733.88	Professional		$350.81	$532.00	$733.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.66 / $168.71 / $267.75	Professional	26	$99.66	$168.71	$267.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.06 / $348.53 / $433.98	Professional	TC	$220.06	$348.53	$433.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $521.10 / $521.10 / $526.26	Professional		$521.10	$521.10	$526.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.23 / $172.42 / $200.32	Professional	26	$81.23	$172.42	$200.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.29 / $495.39 / $550.42	Professional		$374.29	$495.39	$550.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.91 / $150.76 / $167.51	Professional	26	$113.91	$150.76	$167.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.39 / $344.63 / $382.92	Professional	TC	$260.39	$344.63	$382.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.64 / $233.30 / $392.50	Professional		$106.64	$233.30	$392.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.12 / $520.73 / $760.53	Professional		$339.12	$520.73	$760.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.93 / $156.34 / $234.45	Professional	26	$103.93	$156.34	$234.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.83 / $364.65 / $526.07	Professional	TC	$235.83	$364.65	$526.07
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $599.27 / $599.27 / $605.20	Professional		$599.27	$599.27	$605.20
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $137.40 / $202.25 / $230.37	Professional	26	$137.40	$202.25	$230.37
United Facility/Professional Professional Modifier Low / Median / High Price $375.57 / $663.50 / $1,197.83	Professional		$375.57	$663.50	$1,197.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.73 / $129.41 / $215.14	Professional	26	$84.73	$129.41	$215.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.29 / $455.79 / $905.44	Professional	TC	$263.29	$455.79	$905.44