Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.23 / $107.23 / $160.85	Facility	26	$107.23	$107.23	$160.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.13 / $277.14 / $484.71	Professional		$224.13	$277.14	$484.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $101.41 / $171.57	Professional	26	$67.59	$101.41	$171.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.53 / $169.92 / $245.76	Professional	TC	$146.53	$169.92	$245.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.73 / $418.93 / $446.21	Professional		$267.73	$418.93	$446.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $100.83 / $114.28 / $133.05	Professional	26	$100.83	$114.28	$133.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $285.88 / $285.88 / $285.88	Professional	TC	$285.88	$285.88	$285.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.76 / $317.33 / $317.33	Professional		$239.76	$317.33	$317.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.66 / $123.97 / $123.97	Professional	26	$93.66	$123.97	$123.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $146.10 / $193.37 / $193.37	Professional	TC	$146.10	$193.37	$193.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.92 / $145.69 / $285.16	Professional		$79.92	$145.69	$285.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.20 / $340.88 / $484.61	Professional		$242.20	$340.88	$484.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.02 / $127.87 / $183.51	Professional	26	$89.02	$127.87	$183.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.74 / $201.82 / $305.51	Professional	TC	$149.74	$201.82	$305.51
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $307.89 / $348.54 / $513.14	Professional		$307.89	$348.54	$513.14
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $115.95 / $134.86 / $193.27	Professional	26	$115.95	$134.86	$193.27
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $328.76 / $328.76 / $328.76	Professional	TC	$328.76	$328.76	$328.76
United Facility/Professional Professional Modifier Low / Median / High Price $208.70 / $301.45 / $454.38	Professional		$208.70	$301.45	$454.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.61 / $115.86 / $182.04	Professional	26	$78.61	$115.86	$182.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.13 / $188.70 / $308.52	Professional	TC	$129.13	$188.70	$308.52