Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.32 / $113.32 / $167.86	Facility	26	$113.32	$113.32	$167.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.54 / $482.60 / $602.49	Professional		$298.54	$482.60	$602.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.95 / $103.42 / $125.11	Professional	26	$70.95	$103.42	$125.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.58 / $355.54 / $477.37	Professional	TC	$227.58	$355.54	$477.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $169.54 / $169.54 / $169.54	Professional	26	$169.54	$169.54	$169.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $435.01 / $435.01 / $435.01	Professional	TC	$435.01	$435.01	$435.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.08 / $583.78 / $648.64	Professional		$441.08	$583.78	$648.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.75 / $142.61 / $158.46	Professional	26	$107.75	$142.61	$158.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $333.32 / $441.16 / $490.18	Professional	TC	$333.32	$441.16	$490.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $477.17 / $640.10 / $895.52	Professional		$477.17	$640.10	$895.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.91 / $158.05 / $217.99	Professional	26	$110.91	$158.05	$217.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.55 / $466.55 / $665.70	Professional	TC	$363.55	$466.55	$665.70
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $194.97 / $194.97 / $194.97	Professional	26	$194.97	$194.97	$194.97
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $500.26 / $500.26 / $500.26	Professional	TC	$500.26	$500.26	$500.26
United Facility/Professional Professional Modifier Low / Median / High Price $400.95 / $485.52 / $757.14	Professional		$400.95	$485.52	$757.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.14 / $121.41 / $196.02	Professional	26	$95.14	$121.41	$196.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $301.77 / $351.51 / $559.71	Professional	TC	$301.77	$351.51	$559.71