Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $134.90	Facility	26	$74.13	$74.13	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $288.40 / $645.65	Professional		$234.42	$288.40	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $87.10 / $245.47	Professional	26	$51.29	$87.10	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $213.80 / $363.08	Professional	TC	$169.82	$213.80	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $229.09 / $436.52	Professional		$186.21	$229.09	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $89.13	Professional	26	$40.74	$53.70	$89.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $295.12 / $407.38	Professional	TC	$151.36	$295.12	$407.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $371.54	Professional		$281.84	$281.84	$371.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $83.18	Professional	26	$63.10	$63.10	$83.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $218.78 / $288.40	Professional	TC	$218.78	$218.78	$288.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $181.97 / $416.87	Professional		$52.48	$181.97	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $512.86	Professional		$257.04	$407.38	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $97.72 / $134.90	Professional	26	$56.23	$97.72	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $295.12 / $389.05	Professional	TC	$194.98	$295.12	$389.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $575.44	Professional		$354.81	$407.38	$575.44
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $128.82	Professional	26	$69.18	$89.13	$128.82
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $467.74	Professional	TC	$338.84	$338.84	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $512.86	Professional		$245.47	$346.74	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $131.83	Professional	26	$52.48	$81.28	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $263.03 / $389.05	Professional	TC	$190.55	$263.03	$389.05