Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.79 / $58.80 / $73.17	Facility	26	$58.79	$58.80	$73.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $123.37 / $720.00	Professional		$84.00	$123.37	$720.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $58.79 / $389.99	Professional	26	$43.82	$58.79	$389.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.38 / $301.38 / $301.38	Professional	50	$301.38	$301.38	$301.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.17 / $52.53 / $85.15	Professional	TC	$40.17	$52.53	$85.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.96 / $124.62 / $138.15	Professional		$109.96	$124.62	$138.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.93 / $73.01 / $73.01	Professional	26	$49.93	$73.01	$73.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.50 / $122.43 / $122.43	Professional		$92.50	$122.43	$122.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.45 / $62.80 / $62.80	Professional	26	$47.45	$62.80	$62.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.05 / $59.63 / $59.63	Professional	TC	$45.05	$59.63	$59.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.96 / $58.80 / $116.87	Professional		$47.96	$58.80	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.32 / $128.57 / $180.22	Professional		$83.32	$128.57	$180.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.37 / $65.05 / $86.59	Professional	26	$44.37	$65.05	$86.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $58.82 / $93.63	Professional	TC	$39.25	$58.82	$93.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $126.45 / $143.31 / $162.50	Professional		$126.45	$143.31	$162.50
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $62.97 / $69.29 / $83.96	Professional	26	$62.97	$69.29	$83.96
United Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $109.18 / $190.11	Professional		$79.40	$109.18	$190.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.25 / $60.98 / $87.41	Professional	26	$38.25	$60.98	$87.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.94 / $51.97 / $92.71	Professional	TC	$37.94	$51.97	$92.71