Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.71 / $202.72 / $304.08	Facility	26	$202.71	$202.72	$304.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $322.83 / $941.00	Professional		$248.78	$322.83	$941.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $168.77 / $254.43	Professional	26	$144.25	$168.77	$254.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.34 / $106.78 / $152.46	Professional	TC	$95.34	$106.78	$152.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.80 / $327.24 / $404.09	Professional		$218.80	$327.24	$404.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $173.50 / $253.20 / $253.20	Professional	26	$173.50	$253.20	$253.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.22 / $343.09 / $343.09	Professional		$259.22	$343.09	$343.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $163.94 / $216.98 / $216.98	Professional	26	$163.94	$216.98	$216.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.28 / $126.11 / $126.11	Professional	TC	$95.28	$126.11	$126.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.06 / $179.40 / $307.45	Professional		$98.06	$179.40	$307.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.18 / $360.16 / $463.85	Professional		$242.18	$360.16	$463.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $152.49 / $226.24 / $299.62	Professional	26	$152.49	$226.24	$299.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.69 / $132.19 / $164.23	Professional	TC	$89.69	$132.19	$164.23
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $332.05 / $376.33 / $417.16	Professional		$332.05	$376.33	$417.16
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $253.98 / $253.98 / $291.18	Professional	26	$253.98	$253.98	$291.18
United Facility/Professional Professional Modifier Low / Median / High Price $220.91 / $313.74 / $478.03	Professional		$220.91	$313.74	$478.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $134.72 / $203.68 / $303.00	Professional	26	$134.72	$203.68	$303.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.35 / $127.60 / $175.03	Professional	TC	$89.35	$127.60	$175.03