Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $131.83 / $346.74	Facility		$23.44	$131.83	$346.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $11.48 / $13.80	Facility	26	$9.55	$11.48	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $12.02 / $100.00 / $338.84	Facility	TC	$12.02	$100.00	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $23.44 / $66.07	Professional		$16.60	$23.44	$66.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.91 / $32.36	Professional	26	$7.41	$8.91	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $14.45 / $25.12	Professional	TC	$10.00	$14.45	$25.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $19.50 / $44.67	Professional		$16.22	$19.50	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.71 / $14.45	Professional	26	$6.46	$8.71	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $13.18 / $21.38	Professional	TC	$10.96	$13.18	$21.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $104.71	Facility		$75.86	$75.86	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $27.54 / $34.67	Professional		$23.99	$27.54	$34.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.72 / $13.80	Professional	26	$9.33	$10.72	$13.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $16.60 / $21.38	Professional	TC	$14.45	$16.60	$21.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $23.44 / $38.90	Facility		$8.71	$23.44	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $19.50 / $38.02	Professional		$8.51	$19.50	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $107.15 / $229.09	Facility		$16.98	$107.15	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $27.54 / $47.86	Professional		$19.95	$27.54	$47.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.59 / $18.20	Professional	26	$8.32	$12.59	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $15.14 / $29.51	Professional	TC	$10.00	$15.14	$29.51
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $39.81 / $44.67	Professional		$28.84	$39.81	$44.67
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $15.49 / $17.78	Professional	26	$7.41	$15.49	$17.78
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $15.49 / $28.84	Professional	TC	$10.72	$15.49	$28.84
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $138.04 / $257.04	Facility		$107.15	$138.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.70 / $44.67	Professional		$19.05	$25.70	$44.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $16.98	Professional	26	$8.13	$10.23	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $16.22 / $28.18	Professional	TC	$10.47	$16.22	$28.18