Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $776.25 / $1,995.26	Facility		$245.47	$776.25	$1,995.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $91.20 / $630.96	Facility	26	$64.57	$91.20	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $575.44	Professional		$165.96	$245.47	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $190.55	Professional	26	$61.66	$72.44	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $154.88 / $245.47	Professional	TC	$104.71	$154.88	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $380.19	Professional		$141.25	$208.93	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $100.00	Professional	26	$52.48	$67.61	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $141.25 / $181.97	Professional	TC	$85.11	$141.25	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $660.69	Facility		$478.63	$478.63	$660.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $281.84	Professional		$213.80	$213.80	$281.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $107.15	Professional	26	$81.28	$81.28	$107.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $131.83 / $173.78	Professional	TC	$131.83	$131.83	$173.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $114.82 / $194.98	Facility		$69.18	$114.82	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $128.82 / $257.04	Professional		$66.07	$128.82	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $512.86 / $676.08	Facility		$489.78	$512.86	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $416.87	Professional		$194.98	$302.00	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $141.25	Professional	26	$66.07	$100.00	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $204.17 / $281.84	Professional	TC	$125.89	$204.17	$281.84
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $309.03 / $436.52	Professional		$239.88	$309.03	$436.52
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $162.18	Professional	26	$97.72	$112.20	$162.18
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $199.53 / $288.40	Professional	TC	$162.18	$199.53	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $851.14 / $1,621.81	Facility		$660.69	$851.14	$1,621.81
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $426.58	Professional		$181.97	$263.03	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $85.11 / $141.25	Professional	26	$63.10	$85.11	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $165.96 / $295.12	Professional	TC	$117.49	$165.96	$295.12