Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.01 / $17.20 / $20.72	Facility	26	$14.01	$17.20	$20.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.31 / $45.13 / $105.66	Professional		$28.31	$45.13	$105.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $16.44 / $29.23	Professional	26	$11.50	$16.44	$29.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $27.93 / $43.87	Professional	TC	$24.12	$27.93	$43.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $55.52 / $55.52	Professional		$29.05	$55.52	$55.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $20.62 / $22.54	Professional	26	$9.56	$20.62	$22.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.64 / $34.64 / $34.64	Professional	TC	$34.64	$34.64	$34.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.18 / $53.18 / $59.09	Professional		$40.18	$53.18	$59.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.91 / $19.73 / $21.93	Professional	26	$14.91	$19.73	$21.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.27 / $33.44 / $37.15	Professional	TC	$25.27	$33.44	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.50 / $28.73 / $47.48	Professional		$12.50	$28.73	$47.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.81 / $56.41 / $73.56	Professional		$37.81	$56.41	$73.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.34 / $18.61 / $25.25	Professional	26	$12.34	$18.61	$25.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $32.58 / $47.50	Professional	TC	$24.32	$32.58	$47.50
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $63.85 / $79.98	Professional		$52.16	$63.85	$79.98
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $23.71 / $27.00	Professional	26	$16.01	$23.71	$27.00
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $39.84 / $39.84	Professional	TC	$39.84	$39.84	$39.84
United Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $47.35 / $78.26	Professional		$36.29	$47.35	$78.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $15.62 / $25.27	Professional	26	$12.60	$15.62	$25.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $30.28 / $51.35	Professional	TC	$24.18	$30.28	$51.35