Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $57.54 / $64.57	Facility	26	$43.65	$57.54	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $269.15 / $363.08	Professional		$199.53	$269.15	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.48 / $102.33	Professional	26	$34.67	$52.48	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $309.03	Professional	TC	$173.78	$229.09	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $245.47	Professional		$194.98	$194.98	$245.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $74.13	Professional	26	$30.20	$37.15	$74.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $354.81 / $457.09	Professional		$309.03	$354.81	$457.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $53.70 / $67.61	Professional	26	$46.77	$53.70	$67.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $302.00 / $389.05	Professional	TC	$263.03	$302.00	$389.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $446.68 / $537.03	Professional		$89.13	$446.68	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $524.81	Professional		$239.88	$346.74	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $81.28	Professional	26	$41.69	$56.23	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $288.40 / $446.68	Professional	TC	$165.96	$288.40	$446.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $75.86 / $97.72	Professional	26	$72.44	$75.86	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $501.19	Professional		$213.80	$281.84	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $43.65 / $77.62	Professional	26	$38.02	$43.65	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $239.88 / $416.87	Professional	TC	$181.97	$239.88	$416.87