Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.03 / $170.58 / $212.71	Facility	26	$166.03	$170.58	$212.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.72 / $285.92 / $767.16	Professional		$212.72	$285.92	$767.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.34 / $141.09 / $342.24	Professional	26	$120.34	$141.09	$342.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.71 / $95.06 / $137.05	Professional	TC	$84.71	$95.06	$137.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.60 / $280.62 / $307.66	Professional		$247.60	$280.62	$307.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $144.94 / $184.62 / $211.67	Professional	26	$144.94	$184.62	$211.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.97 / $304.37 / $304.37	Professional		$229.97	$304.37	$304.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $137.66 / $182.21 / $182.21	Professional	26	$137.66	$182.21	$182.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.30 / $122.17 / $122.17	Professional	TC	$92.30	$122.17	$122.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.18 / $150.01 / $263.39	Professional		$88.18	$150.01	$263.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.74 / $310.85 / $396.09	Professional		$205.74	$310.85	$396.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.09 / $189.14 / $249.98	Professional	26	$127.09	$189.14	$249.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.66 / $117.60 / $146.11	Professional	TC	$78.66	$117.60	$146.11
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $242.03 / $322.70 / $353.81	Professional		$242.03	$322.70	$353.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $182.56 / $212.31 / $243.42	Professional	26	$182.56	$212.31	$243.42
United Facility/Professional Professional Modifier Low / Median / High Price $190.23 / $271.87 / $416.68	Professional		$190.23	$271.87	$416.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.59 / $178.00 / $303.20	Professional	26	$117.59	$178.00	$303.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.00 / $115.46 / $162.52	Professional	TC	$79.00	$115.46	$162.52