Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.29 / $78.25 / $111.74	Facility	26	$72.29	$78.25	$111.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.46 / $204.51 / $789.81	Professional		$111.46	$204.51	$789.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.74 / $66.37 / $111.74	Professional	26	$48.74	$66.37	$111.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.94 / $66.94 / $110.54	Professional	52	$44.94	$66.94	$110.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.83 / $126.14 / $207.71	Professional	TC	$54.83	$126.14	$207.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $260.58 / $260.58 / $260.58	Professional		$260.58	$260.58	$260.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.17 / $94.57 / $94.57	Professional	26	$40.17	$94.57	$94.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.72 / $187.59 / $187.59	Professional		$141.72	$187.59	$187.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.05 / $71.53 / $71.53	Professional	26	$54.05	$71.53	$71.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.69 / $116.06 / $116.06	Professional	TC	$87.69	$116.06	$116.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.49 / $63.63 / $120.50	Professional		$50.49	$63.63	$120.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.55 / $188.14 / $322.24	Professional		$132.55	$188.14	$322.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.58 / $77.08 / $126.70	Professional	26	$54.58	$77.08	$126.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.81 / $120.73 / $168.97	Professional	TC	$70.81	$120.73	$168.97
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $299.68 / $299.68 / $299.68	Professional		$299.68	$299.68	$299.68
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $61.73 / $102.89 / $108.76	Professional	26	$61.73	$102.89	$108.76
United Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $176.09 / $274.57	Professional		$103.62	$176.09	$274.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.19 / $72.80 / $109.57	Professional	26	$40.19	$72.80	$109.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.50 / $102.07 / $167.75	Professional	TC	$62.50	$102.07	$167.75