Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $123.03	Facility	26	$112.20	$112.20	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $426.58 / $575.44	Professional		$169.82	$426.58	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $239.88	Professional	26	$54.95	$87.10	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $354.81 / $467.74	Professional	TC	$120.23	$354.81	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $67.61 / $134.90	Professional	26	$54.95	$67.61	$134.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $549.54	Professional		$380.19	$436.52	$549.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $91.20 / $117.49	Professional	26	$79.43	$91.20	$117.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $338.84 / $436.52	Professional	TC	$295.12	$338.84	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $676.08	Professional		$389.05	$524.81	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $102.33 / $147.91	Professional	26	$75.86	$102.33	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $426.58 / $537.03	Professional	TC	$316.23	$426.58	$537.03
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $144.54 / $154.88	Professional	26	$134.90	$144.54	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $457.09 / $741.31	Professional		$371.54	$457.09	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $141.25	Professional	26	$69.18	$87.10	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $363.08 / $602.56	Professional	TC	$275.42	$363.08	$602.56