Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.31 / $73.31 / $132.11	Facility	26	$73.31	$73.31	$132.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.78 / $321.50 / $577.35	Professional		$235.78	$321.50	$577.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.00 / $93.06 / $254.49	Professional	26	$52.00	$93.06	$254.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $218.23 / $429.38	Professional	TC	$162.34	$218.23	$429.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $298.60 / $338.41 / $497.66	Professional		$298.60	$338.41	$497.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.50 / $77.61 / $89.95	Professional	26	$40.50	$77.61	$89.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $386.44 / $386.44 / $386.44	Professional	TC	$386.44	$386.44	$386.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.42 / $373.79 / $373.79	Professional		$282.42	$373.79	$373.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.63 / $82.89 / $82.89	Professional	26	$62.63	$82.89	$82.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $219.79 / $290.89 / $290.89	Professional	TC	$219.79	$290.89	$290.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.89 / $201.99 / $319.10	Professional		$52.89	$201.99	$319.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.61 / $412.94 / $514.25	Professional		$260.61	$412.94	$514.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.44 / $94.63 / $132.00	Professional	26	$56.44	$94.63	$132.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.02 / $310.35 / $383.68	Professional	TC	$200.02	$310.35	$383.68
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $343.39 / $343.39 / $572.30	Professional		$343.39	$343.39	$572.30
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $89.25 / $102.42	Professional	26	$69.00	$89.25	$102.42
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $444.41 / $444.41 / $444.41	Professional	TC	$444.41	$444.41	$444.41
United Facility/Professional Professional Modifier Low / Median / High Price $247.18 / $355.65 / $486.57	Professional		$247.18	$355.65	$486.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.34 / $82.51 / $131.97	Professional	26	$55.34	$82.51	$131.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.84 / $274.13 / $401.50	Professional	TC	$191.84	$274.13	$401.50