Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.50 / $89.50 / $117.88	Facility	26	$89.50	$89.50	$117.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.94 / $229.24 / $282.27	Professional		$186.94	$229.24	$282.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.09 / $80.40 / $111.87	Professional	26	$61.09	$80.40	$111.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $121.05 / $148.83 / $169.27	Professional	TC	$121.05	$148.83	$169.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.00 / $105.77 / $140.31	Professional	26	$68.00	$105.77	$140.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.07 / $256.86 / $256.86	Professional		$194.07	$256.86	$256.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.18 / $103.47 / $103.47	Professional	26	$78.18	$103.47	$103.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.89 / $153.38 / $153.38	Professional	TC	$115.89	$153.38	$153.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $112.87 / $223.74	Professional		$66.73	$112.87	$223.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.77 / $271.00 / $407.43	Professional		$179.77	$271.00	$407.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $108.59 / $158.97	Professional	26	$75.86	$108.59	$158.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.80 / $167.01 / $249.39	Professional	TC	$98.80	$167.01	$249.39
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.20 / $121.64 / $161.36	Professional	26	$78.20	$121.64	$161.36
United Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $220.72 / $370.92	Professional		$164.42	$220.72	$370.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $93.74 / $143.47	Professional	26	$65.61	$93.74	$143.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.05 / $132.59 / $232.90	Professional	TC	$100.05	$132.59	$232.90