Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $114.82 / $134.90	Facility	26	$87.10	$114.82	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $758.58	Professional		$323.59	$478.63	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $87.10 / $234.42	Professional	26	$67.61	$87.10	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $416.87 / $575.44	Professional	TC	$275.42	$416.87	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $389.05 / $758.58	Professional		$316.23	$389.05	$758.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $93.33 / $131.83	Professional	26	$61.66	$93.33	$131.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $309.03 / $537.03	Professional	TC	$309.03	$309.03	$537.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $562.34 / $707.95	Professional		$489.78	$562.34	$707.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $95.50 / $123.03	Professional	26	$83.18	$95.50	$123.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $457.09 / $588.84	Professional	TC	$398.11	$457.09	$588.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $724.44 / $912.01	Professional		$186.21	$724.44	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $1,047.13	Professional		$489.78	$660.69	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $177.83	Professional	26	$85.11	$123.03	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $575.44 / $933.25	Professional	TC	$309.03	$575.44	$933.25
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $870.96	Professional		$741.31	$741.31	$870.96
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $151.36 / $173.78	Professional	26	$117.49	$151.36	$173.78
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $630.96 / $630.96	Professional	TC	$630.96	$630.96	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $831.76	Professional		$380.19	$512.86	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $89.13 / $154.88	Professional	26	$74.13	$89.13	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $426.58 / $676.08	Professional	TC	$338.84	$426.58	$676.08