Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.94 / $101.60 / $510.00	Professional		$71.94	$101.60	$510.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $50.52 / $280.50	Professional	26	$23.34	$50.52	$280.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.59 / $54.76 / $113.92	Professional	TC	$48.59	$54.76	$113.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.82 / $84.48 / $103.90	Professional		$82.82	$84.48	$103.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $28.52 / $33.54	Professional	26	$28.52	$28.52	$33.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.06 / $65.06 / $65.06	Professional	TC	$65.06	$65.06	$65.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $86.51 / $114.50	Professional		$25.70	$86.51	$114.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.13 / $34.27 / $42.84	Professional	26	$29.13	$34.27	$42.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.38 / $67.50 / $84.38	Professional	TC	$57.38	$67.50	$84.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.25 / $61.00 / $104.95	Facility		$25.25	$61.00	$104.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $53.83 / $82.30	Professional		$25.25	$53.83	$82.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $65.64 / $121.28	Professional		$31.66	$65.64	$121.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $23.08 / $46.15	Professional	26	$10.70	$23.08	$46.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $45.98 / $88.52	Professional	TC	$20.96	$45.98	$88.52
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $97.15 / $97.62 / $114.08	Professional		$97.15	$97.62	$114.08
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $33.65 / $38.57	Professional	26	$32.79	$33.65	$38.57
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $74.83 / $74.83 / $74.83	Professional	TC	$74.83	$74.83	$74.83
United Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $57.27 / $94.19	Professional		$36.39	$57.27	$94.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $17.75 / $32.54	Professional	26	$12.04	$17.75	$32.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $37.53 / $64.59	Professional	TC	$23.86	$37.53	$64.59