Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.61 / $138.00 / $574.11	Professional		$98.61	$138.00	$574.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.47 / $46.94 / $152.15	Professional	26	$34.47	$46.94	$152.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.14 / $72.28 / $122.93	Professional	TC	$64.14	$72.28	$122.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $208.92	Professional		$102.94	$102.94	$208.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.95 / $48.63 / $85.22	Professional	26	$41.95	$48.63	$85.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.81 / $65.81 / $74.38	Professional	TC	$65.81	$65.81	$74.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $119.07 / $157.59	Professional		$38.11	$119.07	$157.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.21 / $50.83 / $63.54	Professional	26	$43.21	$50.83	$63.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $89.25 / $111.56	Professional	TC	$75.86	$89.25	$111.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.11 / $69.88 / $130.00	Facility		$37.11	$69.88	$130.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $65.29 / $102.40	Professional		$37.11	$65.29	$102.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.42 / $108.45 / $196.67	Professional		$55.42	$108.45	$196.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.70 / $48.72 / $73.54	Professional	26	$19.70	$48.72	$73.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.06 / $50.04 / $116.64	Professional	TC	$27.06	$50.04	$116.64
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $133.77 / $133.77 / $240.26	Professional		$133.77	$133.77	$240.26
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $48.24 / $48.24 / $98.00	Professional	26	$48.24	$48.24	$98.00
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $85.54 / $85.54 / $85.54	Professional	TC	$85.54	$85.54	$85.54
United Facility/Professional Professional Modifier Low / Median / High Price $68.11 / $105.34 / $131.84	Professional		$68.11	$105.34	$131.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.22 / $39.82 / $69.16	Professional	26	$25.22	$39.82	$69.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $48.51 / $83.37	Professional	TC	$39.22	$48.51	$83.37