Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.19 / $113.25 / $132.61	Professional		$85.19	$113.25	$132.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.30 / $84.60 / $100.95	Professional	26	$59.30	$84.60	$100.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.31 / $28.94 / $38.00	Professional	TC	$25.31	$28.94	$38.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.64 / $126.64 / $157.79	Professional		$126.64	$126.64	$157.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.33 / $138.09 / $153.43	Professional		$104.33	$138.09	$153.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.25 / $107.54 / $119.49	Professional	26	$81.25	$107.54	$119.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $30.55 / $33.94	Professional	TC	$23.08	$30.55	$33.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $70.39 / $97.01	Professional		$24.69	$70.39	$97.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $138.12 / $199.95	Professional		$80.23	$138.12	$199.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.86 / $110.87 / $150.01	Professional	26	$61.86	$110.87	$150.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.10 / $28.07 / $44.22	Professional	TC	$22.10	$28.07	$44.22
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $145.63 / $145.63 / $181.46	Professional		$145.63	$145.63	$181.46
United Facility/Professional Professional Modifier Low / Median / High Price $79.73 / $98.74 / $186.51	Professional		$79.73	$98.74	$186.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.17 / $77.09 / $130.50	Professional	26	$61.17	$77.09	$130.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.46 / $23.50 / $45.17	Professional	TC	$17.46	$23.50	$45.17