Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.11 / $50.63 / $53.57	Facility	26	$34.11	$50.63	$53.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $211.65 / $378.25	Professional		$160.91	$211.65	$378.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $40.60 / $77.38	Professional	26	$28.91	$40.60	$77.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.15 / $184.00 / $312.13	Professional	TC	$135.15	$184.00	$312.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $214.60 / $357.67	Professional		$75.00	$214.60	$357.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $52.20 / $61.58	Professional	26	$29.35	$52.20	$61.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $168.55 / $213.16 / $252.34	Professional	TC	$168.55	$213.16	$252.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $270.06 / $270.06	Professional		$204.05	$270.06	$270.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.50 / $57.57 / $57.57	Professional	26	$43.50	$57.57	$57.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.55 / $212.49 / $212.49	Professional	TC	$160.55	$212.49	$212.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.51 / $146.84 / $229.44	Professional		$36.51	$146.84	$229.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.44 / $276.64 / $353.04	Professional		$187.44	$276.64	$353.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $49.01 / $73.37	Professional	26	$35.89	$49.01	$73.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.18 / $225.43 / $288.63	Professional	TC	$145.18	$225.43	$288.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $246.79 / $411.32	Professional		$86.25	$246.79	$411.32
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $52.97 / $66.54 / $70.81	Professional	26	$52.97	$66.54	$70.81
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $193.83 / $229.72 / $323.05	Professional	TC	$193.83	$229.72	$323.05
United Facility/Professional Professional Modifier Low / Median / High Price $174.07 / $248.62 / $344.41	Professional		$174.07	$248.62	$344.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.27 / $42.82 / $74.62	Professional	26	$30.27	$42.82	$74.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.61 / $199.95 / $279.62	Professional	TC	$141.61	$199.95	$279.62