Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $88.25 / $153.16	Professional		$77.86	$88.25	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.21 / $58.21 / $94.34	Professional	26	$51.21	$58.21	$94.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.65 / $27.55 / $44.08	Professional	TC	$26.65	$27.55	$44.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.58 / $91.58 / $167.69	Professional		$91.58	$91.58	$167.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.16 / $62.16 / $62.16	Professional	26	$62.16	$62.16	$62.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.17 / $86.31 / $114.24	Professional		$56.17	$86.31	$114.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.66 / $74.90 / $93.62	Professional	26	$63.66	$74.90	$93.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $26.65 / $33.31	Professional	TC	$22.65	$26.65	$33.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $52.68 / $80.90	Professional		$25.88	$52.68	$80.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.32 / $81.81 / $149.43	Professional		$43.32	$81.81	$149.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $61.58 / $101.09	Professional	26	$29.18	$61.58	$101.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.16 / $22.66 / $40.85	Professional	TC	$12.16	$22.66	$40.85
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $105.32 / $105.32 / $192.84	Professional		$105.32	$105.32	$192.84
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $71.48 / $71.48 / $114.44	Professional	26	$71.48	$71.48	$114.44
United Facility/Professional Professional Modifier Low / Median / High Price $50.87 / $82.40 / $108.96	Professional		$50.87	$82.40	$108.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $52.26 / $84.52	Professional	26	$34.79	$52.26	$84.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.69 / $23.11 / $36.94	Professional	TC	$13.69	$23.11	$36.94