Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $83.18 / $245.47	Professional		$69.18	$83.18	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $234.42	Professional	26	$19.05	$25.70	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $57.54 / $107.15	Professional	TC	$42.66	$57.54	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $95.50	Professional		$50.12	$64.57	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $33.88	Professional	26	$25.70	$26.30	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $100.00	Professional		$66.07	$74.13	$100.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $39.81	Professional	26	$30.20	$30.20	$39.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $58.88	Professional	TC	$44.67	$44.67	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $63.10 / $93.33	Professional		$25.70	$63.10	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $74.13 / $147.91	Professional		$33.88	$74.13	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $28.84 / $50.12	Professional	26	$13.80	$28.84	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $45.71 / $95.50	Professional	TC	$19.95	$45.71	$95.50
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $34.67 / $38.90	Professional	26	$29.51	$34.67	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $61.66 / $112.20	Professional		$38.90	$61.66	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.70 / $39.81	Professional	26	$15.85	$25.70	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.02 / $70.79	Professional	TC	$22.91	$38.02	$70.79