Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.49 / $59.49 / $68.41	Facility	26	$59.49	$59.49	$68.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.40 / $143.44 / $223.20	Professional		$88.40	$143.44	$223.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $46.85 / $88.33	Professional	26	$34.46	$46.85	$88.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $109.40 / $151.87	Professional	TC	$84.52	$109.40	$151.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.48 / $182.93 / $186.58	Professional		$91.48	$182.93	$186.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $55.32 / $56.43	Professional	26	$28.60	$55.32	$56.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $127.61 / $127.61 / $127.61	Professional	TC	$127.61	$127.61	$127.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.36 / $182.36 / $182.36	Professional		$182.36	$182.36	$182.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.49 / $59.49 / $59.49	Professional	26	$59.49	$59.49	$59.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.88 / $122.88 / $122.88	Professional	TC	$122.88	$122.88	$122.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $85.82 / $142.04	Professional		$37.39	$85.82	$142.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $171.42 / $230.99	Professional		$113.14	$171.42	$230.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.64 / $54.17 / $75.34	Professional	26	$36.64	$54.17	$75.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.03 / $116.82 / $155.63	Professional	TC	$77.03	$116.82	$155.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $141.65 / $210.37 / $214.57	Professional		$141.65	$210.37	$214.57
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $63.62 / $63.62 / $64.89	Professional	26	$63.62	$63.62	$64.89
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $146.75 / $146.75 / $146.75	Professional	TC	$146.75	$146.75	$146.75
United Facility/Professional Professional Modifier Low / Median / High Price $122.78 / $167.67 / $232.07	Professional		$122.78	$167.67	$232.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.93 / $53.57 / $75.56	Professional	26	$37.93	$53.57	$75.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.27 / $114.10 / $158.90	Professional	TC	$82.27	$114.10	$158.90