Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $240.15 / $240.15 / $360.23	Facility	26	$240.15	$240.15	$360.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $372.99 / $1,259.00	Professional		$288.05	$372.99	$1,259.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $200.22 / $472.48	Professional	26	$171.18	$200.22	$472.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.29 / $118.37 / $174.46	Professional	TC	$105.29	$118.37	$174.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.44 / $383.56 / $401.11	Professional		$338.44	$383.56	$401.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $262.04 / $262.04 / $300.43	Professional	26	$262.04	$262.04	$300.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $299.81 / $396.81 / $396.81	Professional		$299.81	$396.81	$396.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $194.26 / $257.11 / $257.11	Professional	26	$194.26	$257.11	$257.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $105.55 / $139.69 / $139.69	Professional	TC	$105.55	$139.69	$139.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.23 / $212.86 / $360.24	Professional		$112.23	$212.86	$360.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.76 / $418.77 / $536.62	Professional		$280.76	$418.77	$536.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $180.79 / $268.00 / $355.20	Professional	26	$180.79	$268.00	$355.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.97 / $146.69 / $181.42	Professional	TC	$99.97	$146.69	$181.42
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $389.21 / $441.09 / $526.66	Professional		$389.21	$441.09	$526.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $301.35 / $301.35 / $345.49	Professional	26	$301.35	$301.35	$345.49
United Facility/Professional Professional Modifier Low / Median / High Price $256.22 / $369.17 / $554.17	Professional		$256.22	$369.17	$554.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $165.26 / $235.09 / $359.71	Professional	26	$165.26	$235.09	$359.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.62 / $136.19 / $194.47	Professional	TC	$94.62	$136.19	$194.47