Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $117.49 / $302.00	Facility		$42.66	$117.49	$302.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $16.60 / $19.50	Facility	26	$14.13	$16.60	$19.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $33.88 / $309.03	Facility	TC	$26.92	$33.88	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $57.54	Professional		$23.99	$37.15	$57.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $36.31	Professional	26	$7.08	$12.02	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.12 / $38.90	Professional	TC	$17.78	$25.12	$38.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $27.54 / $64.57	Professional		$23.99	$27.54	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $13.49 / $16.60	Professional	26	$6.61	$13.49	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $39.81 / $45.71	Professional	TC	$38.90	$39.81	$45.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $147.91	Facility		$107.15	$107.15	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $57.54	Professional		$38.90	$44.67	$57.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.85 / $20.42	Professional	26	$13.80	$15.85	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $28.84 / $36.31	Professional	TC	$25.12	$28.84	$36.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $25.12 / $33.88	Facility		$8.71	$25.12	$33.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $24.55 / $44.67	Professional		$8.51	$24.55	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $52.48 / $199.53	Facility		$32.36	$52.48	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $67.61	Professional		$32.36	$48.98	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.22 / $22.91	Professional	26	$9.77	$16.22	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $46.77	Professional	TC	$22.39	$32.36	$46.77
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $67.61	Professional		$60.26	$60.26	$67.61
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.60 / $19.05	Professional	26	$8.71	$16.60	$19.05
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $45.71 / $52.48	Professional	TC	$44.67	$45.71	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $165.96 / $309.03	Facility		$128.82	$165.96	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $38.02 / $64.57	Professional		$31.62	$38.02	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $20.89	Professional	26	$9.12	$12.30	$20.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $25.70 / $44.67	Professional	TC	$22.39	$25.70	$44.67