Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.75 / $73.39 / $83.40	Facility	26	$60.75	$73.39	$83.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.81 / $412.60 / $1,143.00	Professional		$302.81	$412.60	$1,143.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $72.20 / $226.00	Professional	26	$51.54	$72.20	$226.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $335.77 / $576.02	Professional	TC	$251.27	$335.77	$576.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $339.50 / $500.69 / $589.04	Professional		$339.50	$500.69	$589.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.34 / $79.48 / $90.51	Professional	26	$68.34	$79.48	$90.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $344.41 / $455.84 / $455.84	Professional		$344.41	$455.84	$455.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.23 / $78.40 / $78.40	Professional	26	$59.23	$78.40	$78.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $285.18 / $377.44 / $377.44	Professional	TC	$285.18	$377.44	$377.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $370.60 / $470.97	Professional		$64.59	$370.60	$470.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.20 / $376.67 / $686.92	Professional		$196.20	$376.67	$686.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $81.23 / $107.80	Professional	26	$55.08	$81.23	$107.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.36 / $337.81 / $579.12	Professional	TC	$177.36	$337.81	$579.12
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $575.79 / $639.20 / $677.41	Professional		$575.79	$639.20	$677.41
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.59 / $93.15 / $104.80	Professional	26	$78.59	$93.15	$104.80
United Facility/Professional Professional Modifier Low / Median / High Price $182.34 / $358.97 / $689.70	Professional		$182.34	$358.97	$689.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.33 / $71.03 / $118.70	Professional	26	$49.33	$71.03	$118.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.09 / $310.35 / $579.39	Professional	TC	$143.09	$310.35	$579.39