Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.66 / $412.13 / $764.81	Professional		$364.66	$412.13	$764.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.83 / $141.32 / $291.72	Professional	26	$121.83	$141.32	$291.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.97 / $276.30 / $348.54	Professional	TC	$243.97	$276.30	$348.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.94 / $441.96 / $700.00	Professional		$416.94	$441.96	$700.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $145.22 / $168.36 / $233.11	Professional	26	$145.22	$168.36	$233.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $271.72 / $271.72 / $271.72	Professional	TC	$271.72	$271.72	$271.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $381.68 / $505.16	Professional		$131.44	$381.68	$505.16
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.96 / $175.25 / $219.06	Professional	26	$148.96	$175.25	$219.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $232.72 / $273.77 / $342.23	Professional	TC	$232.72	$273.77	$342.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.49 / $238.55 / $367.05	Professional		$128.49	$238.55	$367.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $323.48 / $666.11	Professional		$152.97	$323.48	$666.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.14 / $149.12 / $236.01	Professional	26	$67.14	$149.12	$236.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.52 / $153.30 / $412.76	Professional	TC	$73.52	$153.30	$412.76
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $479.48 / $479.48 / $821.30	Professional		$479.48	$479.48	$821.30
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $167.00 / $171.44 / $268.08	Professional	26	$167.00	$171.44	$268.08
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $312.48 / $312.48 / $312.48	Professional	TC	$312.48	$312.48	$312.48
United Facility/Professional Professional Modifier Low / Median / High Price $193.18 / $258.08 / $427.66	Professional		$193.18	$258.08	$427.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.58 / $122.13 / $179.60	Professional	26	$80.58	$122.13	$179.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.60 / $150.88 / $275.00	Professional	TC	$112.60	$150.88	$275.00