Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $117.49 / $363.08	Facility		$38.02	$117.49	$363.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $14.79 / $17.38	Facility	26	$11.75	$14.79	$17.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $34.67 / $93.33	Professional		$18.62	$34.67	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $26.92	Professional	26	$7.94	$12.02	$26.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $47.86	Professional	TC	$16.98	$25.12	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.90 / $61.66	Professional		$23.44	$30.90	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $18.20	Professional	26	$7.94	$11.22	$18.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $26.30 / $38.90	Professional	TC	$16.60	$26.30	$38.90
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 $35.48 / $39.81 / $51.29	Professional		$35.48	$39.81	$51.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.13 / $18.20	Professional	26	$12.30	$14.13	$18.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.30 / $33.88	Professional	TC	$22.91	$26.30	$33.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $33.11 / $54.95	Facility		$10.72	$33.11	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $27.54 / $52.48	Professional		$10.47	$27.54	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $52.48 / $162.18	Facility		$29.51	$52.48	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $70.79	Professional		$30.90	$46.77	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.49 / $22.39	Professional	26	$10.23	$15.49	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $44.67	Professional	TC	$20.89	$28.18	$44.67
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $52.48 / $70.79	Professional		$35.48	$52.48	$70.79
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.50 / $21.88	Professional	26	$13.49	$19.50	$21.88
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $44.67	Professional	TC	$22.39	$32.36	$44.67
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 $30.90 / $36.31 / $63.10	Professional		$30.90	$36.31	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.59 / $20.89	Professional	26	$10.00	$12.59	$20.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $24.55 / $42.66	Professional	TC	$20.42	$24.55	$42.66