Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.85 / $58.49 / $68.84	Facility	26	$56.85	$58.49	$68.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.34 / $148.08 / $198.77	Professional		$127.34	$148.08	$198.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.92 / $47.98 / $67.90	Professional	26	$42.92	$47.98	$67.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $97.54 / $139.51	Professional	TC	$78.06	$97.54	$139.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.32 / $155.63 / $155.63	Professional		$137.32	$155.63	$155.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.29 / $180.39 / $180.39	Professional		$136.29	$180.39	$180.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.78 / $68.53 / $68.53	Professional	26	$51.78	$68.53	$68.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $111.86 / $111.86	Professional	TC	$84.52	$111.86	$111.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $176.00 / $245.31	Professional		$102.33	$176.00	$245.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $64.48 / $85.81	Professional	26	$44.73	$64.48	$85.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.95 / $113.21 / $164.71	Professional	TC	$83.95	$113.21	$164.71
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $157.91 / $178.97	Professional		$157.91	$157.91	$178.97
United Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $150.46 / $235.55	Professional		$101.72	$150.46	$235.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $57.29 / $87.33	Professional	26	$39.36	$57.29	$87.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.07 / $92.50 / $173.69	Professional	TC	$63.07	$92.50	$173.69