Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $245.47 / $363.08	Facility	26	$245.47	$245.47	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $489.78 / $776.25	Professional		$316.23	$489.78	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $245.47 / $660.69	Professional	26	$186.21	$245.47	$660.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $251.19 / $371.54	Professional	TC	$165.96	$251.19	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $426.58 / $851.14	Professional		$346.74	$426.58	$851.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $218.78 / $363.08	Professional	26	$169.82	$218.78	$363.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	TC	$363.08	$363.08	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $562.34 / $724.44	Professional		$489.78	$562.34	$724.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $263.03 / $338.84	Professional	26	$229.09	$263.03	$338.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $380.19	Professional	TC	$257.04	$295.12	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $1,000.00	Professional		$501.19	$501.19	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $724.44 / $1,096.48	Professional		$549.54	$724.44	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $338.84 / $489.78	Professional	26	$239.88	$338.84	$489.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $363.08 / $575.44	Professional	TC	$275.42	$363.08	$575.44
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $977.24	Professional		$831.76	$831.76	$977.24
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $323.59 / $416.87	Professional	26	$223.87	$323.59	$416.87
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	TC	$416.87	$416.87	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $524.81 / $851.14	Professional		$436.52	$524.81	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $251.19 / $416.87	Professional	26	$199.53	$251.19	$416.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $263.03 / $446.68	Professional	TC	$229.09	$263.03	$446.68