Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.86 / $66.76 / $90.26	Facility	26	$55.86	$66.76	$90.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.22 / $164.74 / $206.43	Professional		$110.22	$164.74	$206.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $52.49 / $108.80	Professional	26	$35.61	$52.49	$108.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.94 / $115.91 / $150.56	Professional	TC	$81.94	$115.91	$150.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.22 / $168.22 / $240.81	Professional		$168.22	$168.22	$240.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.26 / $68.73 / $69.41	Professional	26	$50.26	$68.73	$69.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $163.77 / $216.76	Professional		$39.38	$163.77	$216.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.64 / $52.51 / $59.08	Professional	26	$44.64	$52.51	$59.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $119.14 / $140.16 / $157.68	Professional	TC	$119.14	$140.16	$157.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $96.76 / $147.99	Professional		$38.36	$96.76	$147.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.40 / $144.07 / $254.29	Professional		$76.40	$144.07	$254.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $44.91 / $76.31	Professional	26	$27.27	$44.91	$76.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.72 / $64.66 / $193.05	Professional	TC	$34.72	$64.66	$193.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $193.45 / $193.45 / $276.93	Professional		$193.45	$193.45	$276.93
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $57.80 / $57.80 / $79.04	Professional	26	$57.80	$57.80	$79.04
United Facility/Professional Professional Modifier Low / Median / High Price $85.04 / $128.44 / $184.06	Professional		$85.04	$128.44	$184.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $42.93 / $65.94	Professional	26	$25.82	$42.93	$65.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.83 / $82.94 / $138.22	Professional	TC	$59.83	$82.94	$138.22