Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.46 / $116.08 / $237.32	Professional		$83.46	$116.08	$237.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.76 / $42.30 / $85.64	Professional	26	$28.76	$42.30	$85.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.69 / $65.48 / $148.34	Professional	TC	$54.69	$65.48	$148.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $113.64 / $139.09	Professional		$96.70	$113.64	$139.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.21 / $35.21 / $56.07	Professional	26	$35.21	$35.21	$56.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.06 / $74.06 / $74.06	Professional	TC	$74.06	$74.06	$74.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $99.45 / $131.63	Professional		$31.84	$99.45	$131.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $42.46 / $53.07	Professional	26	$36.09	$42.46	$53.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.36 / $74.54 / $93.18	Professional	TC	$63.36	$74.54	$93.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.16 / $69.58 / $122.39	Facility		$31.16	$69.58	$122.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.16 / $62.86 / $96.17	Professional		$31.16	$62.86	$96.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $93.81 / $156.41	Professional		$48.52	$93.81	$156.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $42.97 / $67.64	Professional	26	$19.98	$42.97	$67.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.66 / $46.69 / $99.44	Professional	TC	$23.66	$46.69	$99.44
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $113.42 / $130.69 / $159.94	Professional		$113.42	$130.69	$159.94
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $40.49 / $41.56 / $64.48	Professional	26	$40.49	$41.56	$64.48
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $85.17 / $85.17 / $85.17	Professional	TC	$85.17	$85.17	$85.17
United Facility/Professional Professional Modifier Low / Median / High Price $49.16 / $67.48 / $119.73	Professional		$49.16	$67.48	$119.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $30.67 / $59.87	Professional	26	$21.00	$30.67	$59.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $42.54 / $70.38	Professional	TC	$28.16	$42.54	$70.38