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 $338.67 / $478.58 / $1,225.00	Professional		$338.67	$478.58	$1,225.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $73.39 / $253.00	Professional	26	$51.32	$73.39	$253.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $390.00 / $686.43	Professional	TC	$287.33	$390.00	$686.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $513.37 / $581.82 / $684.49	Professional		$513.37	$581.82	$684.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.34 / $79.48 / $91.13	Professional	26	$68.34	$79.48	$91.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $404.25 / $535.04 / $535.04	Professional		$404.25	$535.04	$535.04
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 $345.02 / $456.64 / $456.64	Professional	TC	$345.02	$456.64	$456.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $441.63 / $555.69	Professional		$64.59	$441.63	$555.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.00 / $434.55 / $795.36	Professional		$178.00	$434.55	$795.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.90 / $81.68 / $107.80	Professional	26	$54.90	$81.68	$107.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.54 / $412.50 / $687.56	Professional	TC	$159.54	$412.50	$687.56
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $590.38 / $669.09 / $787.16	Professional		$590.38	$669.09	$787.16
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.59 / $91.40 / $104.80	Professional	26	$78.59	$91.40	$104.80
United Facility/Professional Professional Modifier Low / Median / High Price $204.13 / $428.14 / $816.62	Professional		$204.13	$428.14	$816.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.18 / $70.92 / $119.36	Professional	26	$48.18	$70.92	$119.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.58 / $385.85 / $687.98	Professional	TC	$160.58	$385.85	$687.98