Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $143.81 / $155.53 / $267.39	Facility	26	$143.81	$155.53	$267.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $699.70 / $840.04 / $3,296.21	Professional		$699.70	$840.04	$3,296.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.21 / $164.02 / $668.21	Professional	26	$118.21	$164.02	$668.21
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $264.81 / $370.31 / $554.20	Professional	52	$264.81	$370.31	$554.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $519.24 / $629.47 / $2,000.00	Professional	TC	$519.24	$629.47	$2,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $718.10 / $962.13 / $962.13	Professional		$718.10	$962.13	$962.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $144.40 / $189.12 / $240.67	Professional	26	$144.40	$189.12	$240.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $773.00 / $773.00 / $773.00	Professional	TC	$773.00	$773.00	$773.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $622.30 / $823.64 / $823.64	Professional		$622.30	$823.64	$823.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $133.27 / $176.39 / $176.39	Professional	26	$133.27	$176.39	$176.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $489.04 / $647.25 / $647.25	Professional	TC	$489.04	$647.25	$647.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $135.83 / $569.04 / $766.80	Professional		$135.83	$569.04	$766.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $581.77 / $859.09 / $1,182.48	Professional		$581.77	$859.09	$1,182.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.06 / $188.80 / $294.75	Professional	26	$138.06	$188.80	$294.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $455.00 / $682.44 / $887.73	Professional	TC	$455.00	$682.44	$887.73
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $825.82 / $1,106.45 / $1,106.45	Professional		$825.82	$1,106.45	$1,106.45
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $166.06 / $217.49 / $276.77	Professional	26	$166.06	$217.49	$276.77
United Facility/Professional Professional Modifier Low / Median / High Price $506.25 / $746.10 / $1,304.25	Professional		$506.25	$746.10	$1,304.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.63 / $165.04 / $277.39	Professional	26	$100.63	$165.04	$277.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $405.62 / $643.42 / $905.66	Professional	TC	$405.62	$643.42	$905.66