Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.27 / $99.00 / $358.68	Facility		$39.27	$99.00	$358.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.59 / $14.46 / $17.36	Facility	26	$13.59	$14.46	$17.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $39.27 / $65.25	Professional		$24.68	$39.27	$65.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $13.60 / $24.17	Professional	26	$9.41	$13.60	$24.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.08 / $40.90	Professional	TC	$19.76	$25.08	$40.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.73 / $46.73 / $54.28	Professional		$46.73	$46.73	$54.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $16.93 / $19.67	Professional	26	$8.02	$16.93	$19.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.30 / $29.13 / $29.13	Professional	TC	$28.30	$29.13	$29.13
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 $35.09 / $46.45 / $51.61	Professional		$35.09	$46.45	$51.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $16.27 / $18.07	Professional	26	$12.29	$16.27	$18.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $30.18 / $33.53	Professional	TC	$22.80	$30.18	$33.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.10 / $29.89 / $44.94	Facility		$10.10	$29.89	$44.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $25.46 / $41.35	Professional		$10.48	$25.46	$41.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $53.76 / $112.48	Facility		$29.78	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.94 / $45.53 / $63.75	Professional		$32.94	$45.53	$63.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $15.44 / $20.96	Professional	26	$10.22	$15.44	$20.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $28.45 / $41.92	Professional	TC	$21.01	$28.45	$41.92
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $53.74 / $53.74 / $53.74	Professional		$53.74	$53.74	$53.74
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.23 / $22.62	Professional	26	$13.49	$20.23	$22.62
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $32.54 / $32.54 / $44.69	Professional	TC	$32.54	$32.54	$44.69
United Facility/Professional Professional Modifier Low / Median / High Price $31.02 / $38.26 / $64.95	Professional		$31.02	$38.26	$64.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $12.66 / $21.16	Professional	26	$10.60	$12.66	$21.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.72 / $44.17	Professional	TC	$20.42	$26.72	$44.17