Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.88 / $141.72 / $170.80	Facility	26	$114.88	$141.72	$170.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.54 / $179.81 / $923.20	Professional		$89.54	$179.81	$923.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $114.88 / $151.22	Professional	26	$72.09	$114.88	$151.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $47.43 / $228.06	Professional	TC	$17.45	$47.43	$228.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $225.74 / $225.74 / $262.27	Professional		$225.74	$225.74	$262.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $166.59 / $169.82 / $177.01	Professional	26	$166.59	$169.82	$177.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $56.82 / $56.82	Professional	TC	$56.82	$56.82	$56.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.96 / $175.98 / $195.53	Professional		$132.96	$175.98	$195.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.23 / $144.57 / $160.63	Professional	26	$109.23	$144.57	$160.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.73 / $31.41 / $34.90	Professional	TC	$23.73	$31.41	$34.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.32 / $229.58 / $788.82	Professional		$163.32	$229.58	$788.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.39 / $164.75 / $229.00	Professional	26	$108.39	$164.75	$229.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.74 / $59.97 / $362.44	Professional	TC	$35.74	$59.97	$362.44
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $259.60 / $259.60 / $301.62	Professional		$259.60	$259.60	$301.62
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $156.52 / $195.29 / $203.56	Professional	26	$156.52	$195.29	$203.56
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $65.34 / $65.34 / $65.34	Professional	TC	$65.34	$65.34	$65.34
United Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $229.08 / $634.12	Professional		$119.00	$229.08	$634.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.40 / $120.75 / $199.44	Professional	26	$96.40	$120.75	$199.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $54.01 / $429.90	Professional	TC	$23.38	$54.01	$429.90