Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.71 / $111.64 / $168.07	Professional		$98.71	$111.64	$168.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $41.24 / $59.83	Professional	26	$36.24	$41.24	$59.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.47 / $70.41 / $108.24	Professional	TC	$62.47	$70.41	$108.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.69 / $113.69 / $260.58	Professional		$113.69	$113.69	$260.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $44.03 / $92.37	Professional	26	$44.03	$44.03	$92.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.09 / $123.39 / $163.31	Professional		$41.09	$123.39	$163.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.57 / $54.78 / $68.48	Professional	26	$46.57	$54.78	$68.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.83 / $90.38 / $112.98	Professional	TC	$76.83	$90.38	$112.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $61.15 / $100.12	Professional		$38.97	$61.15	$100.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $132.37 / $206.88	Professional		$67.48	$132.37	$206.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $52.04 / $78.23	Professional	26	$20.73	$52.04	$78.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.77 / $73.00 / $124.02	Professional	TC	$36.77	$73.00	$124.02
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $299.68 / $299.68 / $299.68	Professional		$299.68	$299.68	$299.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $50.63 / $50.63 / $106.23	Professional	26	$50.63	$50.63	$106.23
United Facility/Professional Professional Modifier Low / Median / High Price $69.34 / $108.35 / $167.96	Professional		$69.34	$108.35	$167.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.82 / $42.52 / $67.73	Professional	26	$26.82	$42.52	$67.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.78 / $66.06 / $98.53	Professional	TC	$39.78	$66.06	$98.53