Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $17.38 / $20.89	Facility	26	$15.85	$17.38	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $40.74 / $104.71	Professional		$17.78	$40.74	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.14 / $34.67	Professional	26	$10.47	$15.14	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $58.88	Professional	TC	$19.05	$28.18	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $74.13	Professional		$26.92	$37.15	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $22.91	Professional	26	$9.55	$12.59	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $47.86	Professional	TC	$22.39	$30.90	$47.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $58.88	Professional		$39.81	$45.71	$58.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.98 / $21.88	Professional	26	$14.79	$16.98	$21.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $28.84 / $37.15	Professional	TC	$25.12	$28.84	$37.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $30.90 / $60.26	Professional		$12.59	$30.90	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $77.62	Professional		$35.48	$56.23	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $18.62 / $27.54	Professional	26	$12.30	$18.62	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.11 / $51.29	Professional	TC	$23.99	$33.11	$51.29
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $85.11	Professional		$47.86	$61.66	$85.11
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $23.44 / $26.92	Professional	26	$10.72	$23.44	$26.92
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $32.36 / $53.70	Professional	TC	$26.30	$32.36	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $74.13	Professional		$36.31	$42.66	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $25.12	Professional	26	$12.02	$15.14	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $27.54 / $50.12	Professional	TC	$23.99	$27.54	$50.12