Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.05 / $81.78 / $256.80	Facility		$43.05	$81.78	$256.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.82 / $15.94 / $19.84	Facility	26	$13.82	$15.94	$19.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.11 / $39.50 / $348.79	Facility	TC	$27.11	$39.50	$348.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.18 / $43.04 / $55.69	Professional		$29.18	$43.04	$55.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.27 / $40.82	Professional	26	$7.94	$15.27	$40.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $27.11 / $37.49	Professional	TC	$21.00	$27.11	$37.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.15 / $15.31 / $19.80	Professional	26	$7.15	$15.31	$19.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.86 / $40.86 / $40.86	Professional	TC	$40.86	$40.86	$40.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $107.60 / $117.07	Facility		$107.60	$107.60	$117.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $51.26 / $56.96	Professional		$38.72	$51.26	$56.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.81 / $18.28 / $20.30	Professional	26	$13.81	$18.28	$20.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $32.99 / $36.65	Professional	TC	$24.92	$32.99	$36.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.22 / $31.41 / $43.93	Facility		$8.22	$31.41	$43.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $26.76 / $40.47	Professional		$8.50	$26.76	$40.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.59 / $53.76 / $121.80	Facility		$32.59	$53.76	$121.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $50.25 / $65.33	Professional		$32.65	$50.25	$65.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $16.89 / $22.42	Professional	26	$10.93	$16.89	$22.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.66 / $32.72 / $43.78	Professional	TC	$22.66	$32.72	$43.78
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $17.61 / $22.77	Professional	26	$8.22	$17.61	$22.77
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $45.16 / $45.16 / $46.99	Professional	TC	$45.16	$45.16	$46.99
United Facility/Professional Facility Modifier Low / Median / High Price $109.72 / $167.74 / $317.23	Facility		$109.72	$167.74	$317.23
United Facility/Professional Professional Modifier Low / Median / High Price $33.25 / $40.38 / $64.95	Professional		$33.25	$40.38	$64.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $12.35 / $19.95	Professional	26	$9.74	$12.35	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.29 / $25.84 / $46.11	Professional	TC	$22.29	$25.84	$46.11