Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.65 / $136.65 / $204.98	Facility	26	$136.65	$136.65	$204.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.99 / $242.40 / $808.54	Professional		$175.99	$242.40	$808.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $120.29 / $519.41	Professional	26	$96.29	$120.29	$519.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.73 / $82.73 / $121.40	Professional	TC	$73.73	$82.73	$121.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $233.40 / $304.58	Professional		$175.05	$233.40	$304.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $116.00 / $147.96 / $169.63	Professional	26	$116.00	$147.96	$169.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.00 / $252.79 / $252.79	Professional		$191.00	$252.79	$252.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.29 / $145.97 / $145.97	Professional	26	$110.29	$145.97	$145.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $106.82 / $106.82	Professional	TC	$80.70	$106.82	$106.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.11 / $120.26 / $218.94	Professional		$78.11	$120.26	$218.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $258.27 / $327.49	Professional		$169.00	$258.27	$327.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.55 / $152.09 / $200.34	Professional	26	$101.55	$152.09	$200.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $102.34 / $127.15	Professional	TC	$67.45	$102.34	$127.15
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $236.83 / $268.41 / $350.27	Professional		$236.83	$268.41	$350.27
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $161.15 / $170.15 / $195.07	Professional	26	$161.15	$170.15	$195.07
United Facility/Professional Professional Modifier Low / Median / High Price $156.49 / $219.97 / $346.70	Professional		$156.49	$219.97	$346.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.93 / $130.87 / $204.83	Professional	26	$89.93	$130.87	$204.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.56 / $95.06 / $145.60	Professional	TC	$67.56	$95.06	$145.60