Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.01 / $164.01 / $246.02	Facility	26	$164.01	$164.01	$246.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.11 / $296.83 / $378.73	Professional		$193.11	$296.83	$378.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.20 / $151.16 / $182.28	Professional	26	$102.20	$151.16	$182.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.91 / $141.33 / $196.43	Professional	TC	$90.91	$141.33	$196.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $126.19 / $231.46 / $246.41	Professional	26	$126.19	$231.46	$246.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $201.61 / $201.61 / $201.61	Professional	TC	$201.61	$201.61	$201.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.69 / $376.79 / $418.66	Professional		$284.69	$376.79	$418.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $155.84 / $206.26 / $229.18	Professional	26	$155.84	$206.26	$229.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.85 / $170.53 / $189.48	Professional	TC	$128.85	$170.53	$189.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.04 / $421.38 / $593.12	Professional		$311.04	$421.38	$593.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $161.12 / $228.46 / $315.51	Professional	26	$161.12	$228.46	$315.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.58 / $190.68 / $272.05	Professional	TC	$148.58	$190.68	$272.05
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $266.18 / $278.95 / $283.37	Professional	26	$266.18	$278.95	$283.37
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $231.85 / $231.85 / $231.85	Professional	TC	$231.85	$231.85	$231.85
United Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $320.41 / $516.91	Professional		$257.45	$320.41	$516.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $136.90 / $175.91 / $283.23	Professional	26	$136.90	$175.91	$283.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.43 / $140.54 / $230.28	Professional	TC	$118.43	$140.54	$230.28