Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.35 / $96.68 / $171.60	Professional		$85.35	$96.68	$171.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.20 / $58.20 / $115.60	Professional	26	$51.20	$58.20	$115.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $36.25 / $47.02	Professional	TC	$34.15	$36.25	$47.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.65 / $100.65 / $158.88	Professional		$100.65	$100.65	$158.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.42 / $72.36 / $98.96	Professional	26	$62.42	$72.36	$98.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $93.31 / $123.50	Professional		$56.12	$93.31	$123.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.61 / $74.83 / $93.54	Professional	26	$63.61	$74.83	$93.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.70 / $34.94 / $43.68	Professional	TC	$29.70	$34.94	$43.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.60 / $56.55 / $111.18	Facility		$33.60	$56.55	$111.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $55.25 / $88.84	Professional		$33.60	$55.25	$88.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $100.22 / $160.19	Professional		$45.71	$100.22	$160.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $63.78 / $103.48	Professional	26	$29.15	$63.78	$103.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.01 / $30.85 / $52.41	Professional	TC	$13.01	$30.85	$52.41
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $115.75 / $182.72	Professional		$115.75	$115.75	$182.72
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $71.78 / $83.21 / $113.80	Professional	26	$71.78	$83.21	$113.80
United Facility/Professional Professional Modifier Low / Median / High Price $55.12 / $80.52 / $130.43	Professional		$55.12	$80.52	$130.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.70 / $52.26 / $84.92	Professional	26	$34.70	$52.26	$84.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.97 / $21.22 / $35.01	Professional	TC	$17.97	$21.22	$35.01