Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.72 / $148.72 / $148.72	Facility		$148.72	$148.72	$148.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.88 / $18.88 / $18.88	Facility	26	$18.88	$18.88	$18.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.01 / $137.35 / $223.86	Professional		$107.01	$137.35	$223.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.32 / $32.56	Professional	26	$11.77	$22.32	$32.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.18 / $114.12 / $163.27	Professional	TC	$94.18	$114.12	$163.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.78 / $103.78 / $250.71	Professional		$103.78	$103.78	$250.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.45 / $101.45 / $101.45	Facility		$101.45	$101.45	$101.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.24 / $208.11 / $231.23	Professional		$157.24	$208.11	$231.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.31 / $34.82 / $38.69	Professional	26	$26.31	$34.82	$38.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $130.93 / $173.29 / $192.54	Professional	TC	$130.93	$173.29	$192.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.43 / $118.87 / $131.27	Facility		$107.43	$118.87	$131.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.78 / $210.49 / $274.58	Professional		$139.78	$210.49	$274.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $24.53 / $43.99	Professional	26	$14.79	$24.53	$43.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.84 / $187.87 / $251.65	Professional	TC	$114.84	$187.87	$251.65
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $189.23 / $189.23 / $288.32	Professional		$189.23	$189.23	$288.32
United Facility/Professional Professional Modifier Low / Median / High Price $129.91 / $170.42 / $264.20	Professional		$129.91	$170.42	$264.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $24.85 / $42.55	Professional	26	$14.30	$24.85	$42.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.89 / $148.85 / $240.28	Professional	TC	$112.89	$148.85	$240.28