Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.20 / $50.50 / $88.26	Facility	26	$41.20	$50.50	$88.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.33 / $180.87 / $379.95	Professional		$138.33	$180.87	$379.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $56.89 / $157.04	Professional	26	$34.65	$56.89	$157.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.18 / $130.37 / $207.90	Professional	TC	$94.18	$130.37	$207.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.99 / $215.08 / $232.29	Professional		$133.99	$215.08	$232.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.59 / $52.54 / $62.67	Professional	26	$34.59	$52.54	$62.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $225.20 / $225.20 / $225.20	Professional	TC	$225.20	$225.20	$225.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.04 / $221.08 / $221.08	Professional		$167.04	$221.08	$221.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.39 / $57.43 / $57.43	Professional	26	$43.39	$57.43	$57.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.64 / $163.65 / $163.65	Professional	TC	$123.64	$163.65	$163.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $117.81 / $193.79	Professional		$36.74	$117.81	$193.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.36 / $248.01 / $298.00	Professional		$157.36	$248.01	$298.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.02 / $65.81 / $89.00	Professional	26	$39.02	$65.81	$89.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.38 / $172.42 / $217.14	Professional	TC	$115.38	$172.42	$217.14
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $211.42 / $247.34 / $262.19	Professional		$211.42	$247.34	$262.19
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $59.33 / $62.00 / $72.06	Professional	26	$59.33	$62.00	$72.06
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $258.98 / $258.98 / $258.98	Professional	TC	$258.98	$258.98	$258.98
United Facility/Professional Professional Modifier Low / Median / High Price $150.71 / $212.86 / $288.08	Professional		$150.71	$212.86	$288.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.49 / $55.05 / $90.18	Professional	26	$38.49	$55.05	$90.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.21 / $152.63 / $212.69	Professional	TC	$110.21	$152.63	$212.69