Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.50 / $289.00 / $522.28	Professional		$241.50	$289.00	$522.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.31 / $105.21 / $438.62	Professional	26	$69.31	$105.21	$438.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.52 / $195.57 / $249.83	Professional	TC	$173.52	$195.57	$249.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.66 / $277.60 / $470.61	Professional		$245.66	$277.60	$470.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.44 / $124.19 / $133.27	Professional	26	$84.44	$124.19	$133.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $195.34 / $195.34 / $195.34	Professional	TC	$195.34	$195.34	$195.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $250.12 / $331.05	Professional		$74.38	$250.12	$331.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.29 / $99.17 / $123.96	Professional	26	$84.29	$99.17	$123.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.83 / $195.10 / $243.87	Professional	TC	$165.83	$195.10	$243.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.84 / $183.74 / $311.39	Facility		$72.84	$183.74	$311.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $159.68 / $244.43	Professional		$72.84	$159.68	$244.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.81 / $229.66 / $436.04	Professional		$108.81	$229.66	$436.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.83 / $84.59 / $133.90	Professional	26	$38.83	$84.59	$133.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.29 / $107.93 / $292.32	Professional	TC	$53.29	$107.93	$292.32
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $319.24 / $319.24 / $541.20	Professional		$319.24	$319.24	$541.20
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $94.60 / $97.12 / $151.74	Professional	26	$94.60	$97.12	$151.74
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $224.64 / $224.64 / $224.64	Professional	TC	$224.64	$224.64	$224.64
United Facility/Professional Professional Modifier Low / Median / High Price $141.15 / $182.85 / $281.50	Professional		$141.15	$182.85	$281.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.14 / $69.30 / $112.61	Professional	26	$46.14	$69.30	$112.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.86 / $115.00 / $194.88	Professional	TC	$82.86	$115.00	$194.88