Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.75 / $333.44 / $508.87	Professional		$233.75	$333.44	$508.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.81 / $60.10 / $130.29	Professional	26	$52.81	$60.10	$130.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $276.55 / $311.67 / $613.94	Professional	TC	$276.55	$311.67	$613.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $275.00 / $372.25	Professional		$275.00	$275.00	$372.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.81 / $65.81 / $100.61	Professional	26	$65.81	$65.81	$100.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $356.51 / $471.85	Professional		$58.23	$356.51	$471.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $77.64 / $97.05	Professional	26	$65.98	$77.64	$97.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $290.52 / $341.78 / $427.23	Professional	TC	$290.52	$341.78	$427.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $214.12 / $327.11	Professional		$58.21	$214.12	$327.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.20 / $206.57 / $522.52	Professional		$100.20	$206.57	$522.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $65.59 / $113.49	Professional	26	$30.44	$65.59	$113.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.90 / $158.63 / $503.40	Professional	TC	$67.90	$158.63	$503.40
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $428.09 / $428.09 / $428.09	Professional		$428.09	$428.09	$428.09
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $75.69 / $75.69 / $87.76	Professional	26	$75.69	$75.69	$87.76
United Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $216.22 / $411.78	Professional		$115.65	$216.22	$411.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.53 / $53.99 / $89.35	Professional	26	$36.53	$53.99	$89.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.98 / $177.31 / $344.29	Professional	TC	$77.98	$177.31	$344.29