Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.38 / $261.67 / $732.16	Facility		$161.38	$261.67	$732.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.87 / $27.87 / $33.63	Facility	26	$27.87	$27.87	$33.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.86 / $161.38 / $273.39	Professional		$112.86	$161.38	$273.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.01 / $27.87 / $47.53	Professional	26	$20.01	$27.87	$47.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $49.88 / $80.70 / $130.84	Professional	52	$49.88	$80.70	$130.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.52 / $133.52 / $225.88	Professional	TC	$100.52	$133.52	$225.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.63 / $167.33 / $215.52	Professional		$147.63	$167.33	$215.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.66 / $34.64 / $42.77	Professional	26	$25.66	$34.64	$42.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.78 / $178.38 / $178.38	Professional		$134.78	$178.38	$178.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $31.69 / $31.69	Professional	26	$23.94	$31.69	$31.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.83 / $146.69 / $146.69	Professional	TC	$110.83	$146.69	$146.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.14 / $116.02 / $151.51	Facility		$21.14	$116.02	$151.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.34 / $106.39 / $158.24	Professional		$20.34	$106.39	$158.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.85 / $151.38 / $270.41	Facility		$108.85	$151.38	$270.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.60 / $189.38 / $234.76	Professional		$125.60	$189.38	$234.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $31.66 / $42.42	Professional	26	$21.08	$31.66	$42.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.23 / $159.03 / $200.75	Professional	TC	$103.23	$159.03	$200.75
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $169.79 / $169.79 / $247.85	Professional		$169.79	$169.79	$247.85
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.84 / $49.19	Professional	26	$29.51	$39.84	$49.19
United Facility/Professional Professional Modifier Low / Median / High Price $112.03 / $164.63 / $229.95	Professional		$112.03	$164.63	$229.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.34 / $29.04 / $41.55	Professional	26	$20.34	$29.04	$41.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.65 / $142.33 / $193.07	Professional	TC	$97.65	$142.33	$193.07