Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.46 / $102.46 / $153.69	Facility	26	$102.46	$102.46	$153.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.78 / $183.99 / $486.00	Professional		$133.78	$183.99	$486.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $90.03 / $379.00	Professional	26	$72.04	$90.03	$379.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.62 / $63.56 / $95.34	Professional	TC	$57.62	$63.56	$95.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.36 / $178.35 / $229.26	Professional		$157.36	$178.35	$229.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $111.12 / $127.40	Professional	26	$87.09	$111.12	$127.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.51 / $192.59 / $192.59	Professional		$145.51	$192.59	$192.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.69 / $109.44 / $109.44	Professional	26	$82.69	$109.44	$109.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.83 / $83.15 / $83.15	Professional	TC	$62.83	$83.15	$83.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.34 / $90.34 / $167.31	Professional		$61.34	$90.34	$167.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.53 / $196.56 / $250.00	Professional		$128.53	$196.56	$250.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.15 / $113.42 / $150.69	Professional	26	$76.15	$113.42	$150.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.38 / $79.92 / $99.30	Professional	TC	$52.38	$79.92	$99.30
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $180.96 / $225.19 / $263.64	Professional		$180.96	$225.19	$263.64
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $127.79 / $127.79 / $146.51	Professional	26	$127.79	$127.79	$146.51
United Facility/Professional Professional Modifier Low / Median / High Price $120.80 / $170.76 / $263.48	Professional		$120.80	$170.76	$263.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.30 / $97.95 / $153.19	Professional	26	$67.30	$97.95	$153.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.54 / $73.55 / $112.24	Professional	TC	$52.54	$73.55	$112.24