Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $588.84 / $676.08	Facility	26	$457.09	$588.84	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,041.74 / $3,235.94	Professional		$1,348.96	$2,041.74	$3,235.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $457.09 / $1,659.59	Professional	26	$338.84	$457.09	$1,659.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,000.00 / $1,548.82 / $2,290.87	Professional	TC	$1,000.00	$1,548.82	$2,290.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,513.56 / $3,467.37	Professional		$1,380.38	$1,513.56	$3,467.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $446.68 / $676.08	Professional	26	$323.59	$446.68	$676.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Professional	TC	$2,089.30	$2,089.30	$2,089.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,137.96 / $2,754.23	Professional		$1,862.09	$2,137.96	$2,754.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $489.78 / $630.96	Professional	26	$426.58	$489.78	$630.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,412.54 / $1,621.81 / $2,089.30	Professional	TC	$1,412.54	$1,621.81	$2,089.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $2,884.03 / $3,801.89	Professional		$954.99	$2,884.03	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,754.23 / $4,365.16	Professional		$1,778.28	$2,754.23	$4,365.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $436.52 / $630.96 / $912.01	Professional	26	$436.52	$630.96	$912.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.93 / $2,137.96 / $3,388.44	Professional	TC	$1,258.93	$2,137.96	$3,388.44
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,981.07	Professional		$3,162.28	$3,162.28	$3,981.07
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $602.56 / $616.60 / $831.76	Professional	26	$602.56	$616.60	$831.76
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Professional	TC	$2,398.83	$2,398.83	$2,398.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,041.74 / $3,235.94	Professional		$1,548.82	$2,041.74	$3,235.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $457.09 / $776.25	Professional	26	$380.19	$457.09	$776.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,288.25 / $1,621.81 / $2,454.71	Professional	TC	$1,288.25	$1,621.81	$2,454.71