Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.66 / $58.66 / $87.99	Facility	26	$58.66	$58.66	$87.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $391.99 / $638.79	Professional		$292.89	$391.99	$638.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $159.33 / $202.06 / $218.47	Professional	52	$159.33	$202.06	$218.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $343.73 / $569.08	Professional	TC	$252.77	$343.73	$569.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $423.54 / $423.54 / $423.54	Professional		$423.54	$423.54	$423.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.56 / $433.54 / $433.54	Professional		$327.56	$433.54	$433.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $280.20 / $370.87 / $370.87	Professional	TC	$280.20	$370.87	$370.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.59 / $366.13 / $460.66	Professional		$51.59	$366.13	$460.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.64 / $439.99 / $651.49	Professional		$297.64	$439.99	$651.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $252.43 / $370.17 / $565.49	Professional	TC	$252.43	$370.17	$565.49
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $487.07 / $487.07 / $487.07	Professional		$487.07	$487.07	$487.07
United Facility/Professional Professional Modifier Low / Median / High Price $267.43 / $388.10 / $647.48	Professional		$267.43	$388.10	$647.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.33 / $336.91 / $569.66	Professional	TC	$236.33	$336.91	$569.66