Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.97 / $78.97 / $118.46	Facility	26	$78.97	$78.97	$118.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.39 / $103.85 / $163.19	Professional		$86.39	$103.85	$163.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.13 / $69.73 / $92.95	Professional	26	$50.13	$69.73	$92.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.89 / $31.88 / $47.30	Professional	TC	$24.89	$31.88	$47.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $132.47 / $206.77	Professional		$110.00	$132.47	$206.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.74 / $83.74 / $98.28	Professional	26	$83.74	$83.74	$98.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.08 / $121.35 / $128.47	Professional		$97.08	$121.35	$128.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.98 / $86.24 / $91.31	Professional	26	$68.98	$86.24	$91.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.08 / $35.11 / $37.17	Professional	TC	$28.08	$35.11	$37.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.78 / $66.80 / $124.15	Professional		$47.78	$66.80	$124.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.42 / $138.18 / $179.47	Professional		$89.42	$138.18	$179.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.65 / $91.71 / $117.88	Professional	26	$56.65	$91.71	$117.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.22 / $39.20 / $62.83	Professional	TC	$29.22	$39.20	$62.83
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $126.50 / $152.35 / $237.79	Professional		$126.50	$152.35	$237.79
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $96.30 / $96.30 / $98.82	Professional	26	$96.30	$96.30	$98.82
United Facility/Professional Professional Modifier Low / Median / High Price $83.47 / $106.48 / $156.44	Professional		$83.47	$106.48	$156.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $75.44 / $112.46	Professional	26	$55.22	$75.44	$112.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.87 / $35.56 / $61.10	Professional	TC	$26.87	$35.56	$61.10