Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.02 / $119.85 / $314.62	Facility		$36.02	$119.85	$314.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.34 / $13.77 / $44.20	Facility	26	$10.34	$13.77	$44.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.23 / $221.96 / $370.51	Facility	TC	$22.23	$221.96	$370.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $38.18 / $169.69	Professional		$27.58	$38.18	$169.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $13.78 / $55.00	Professional	26	$9.51	$13.78	$55.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $22.23 / $43.35	Professional	TC	$17.92	$22.23	$43.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.25 / $47.28 / $49.95	Professional		$39.25	$47.28	$49.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $17.04 / $19.11	Professional	26	$9.57	$17.04	$19.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $30.23 / $33.50	Professional	TC	$25.10	$30.23	$33.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.62 / $76.62 / $83.36	Facility		$76.62	$76.62	$83.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.32 / $40.13 / $44.59	Professional		$30.32	$40.13	$44.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $14.86 / $16.51	Professional	26	$11.23	$14.86	$16.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $25.27 / $28.08	Professional	TC	$19.09	$25.27	$28.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.81 / $26.82 / $41.37	Facility		$9.81	$26.82	$41.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.18 / $22.85 / $37.99	Professional		$10.18	$22.85	$37.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.30 / $100.68 / $161.54	Facility		$23.30	$100.68	$161.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $40.28 / $60.01	Professional		$28.64	$40.28	$60.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $14.88 / $20.37	Professional	26	$9.93	$14.88	$20.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.37 / $39.83	Professional	TC	$18.62	$25.37	$39.83
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $54.37 / $57.44 / $65.26	Professional		$54.37	$57.44	$65.26
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.02 / $19.60 / $21.98	Professional	26	$16.02	$19.60	$21.98
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $34.76 / $40.08	Professional	TC	$28.87	$34.76	$40.08
United Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $35.28 / $59.43	Professional		$28.58	$35.28	$59.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $13.04 / $21.45	Professional	26	$9.99	$13.04	$21.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $22.55 / $39.61	Professional	TC	$17.94	$22.55	$39.61