Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.34 / $229.22 / $545.10	Facility		$224.34	$229.22	$545.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.68 / $49.94 / $53.40	Facility	26	$40.68	$49.94	$53.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.65 / $216.02 / $391.85	Professional		$158.65	$216.02	$391.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $46.37 / $84.64	Professional	26	$30.82	$46.37	$84.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.31 / $171.60 / $271.39	Professional	TC	$119.31	$171.60	$271.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.69 / $242.60 / $341.15	Professional		$204.69	$242.60	$341.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.92 / $40.00 / $61.03	Professional	26	$34.92	$40.00	$61.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.67 / $221.67 / $221.67	Facility		$221.67	$221.67	$221.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.11 / $252.94 / $252.94	Professional		$191.11	$252.94	$252.94
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.55 / $56.32 / $56.32	Professional	26	$42.55	$56.32	$56.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.55 / $196.61 / $196.61	Professional	TC	$148.55	$196.61	$196.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.75 / $151.24 / $210.57	Facility		$37.75	$151.24	$210.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $138.36 / $219.93	Professional		$36.39	$138.36	$219.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.80 / $205.64 / $434.20	Facility		$142.80	$205.64	$434.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.03 / $274.24 / $330.20	Professional		$175.03	$274.24	$330.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $52.31 / $72.03	Professional	26	$36.90	$52.31	$72.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.35 / $212.03 / $266.80	Professional	TC	$138.35	$212.03	$266.80
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $235.39 / $278.99 / $392.32	Professional		$235.39	$278.99	$392.32
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $46.00 / $59.85 / $70.18	Professional	26	$46.00	$59.85	$70.18
United Facility/Professional Professional Modifier Low / Median / High Price $167.65 / $233.33 / $328.42	Professional		$167.65	$233.33	$328.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.28 / $44.46 / $73.83	Professional	26	$32.28	$44.46	$73.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.87 / $181.22 / $271.99	Professional	TC	$131.87	$181.22	$271.99