Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.27 / $127.50 / $332.86	Facility		$39.27	$127.50	$332.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.74 / $14.19 / $17.92	Facility	26	$11.74	$14.19	$17.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.07 / $159.41 / $282.63	Facility	TC	$25.07	$159.41	$282.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $44.54 / $96.94	Professional		$35.10	$44.54	$96.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $14.19 / $32.40	Professional	26	$9.78	$14.19	$32.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.09 / $28.63 / $50.15	Professional	TC	$24.09	$28.63	$50.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.13 / $59.20 / $65.36	Professional		$51.13	$59.20	$65.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $17.07 / $19.67	Professional	26	$8.02	$17.07	$19.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.99 / $32.99 / $43.36	Professional	TC	$32.99	$32.99	$43.36
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 $37.22 / $49.26 / $54.73	Professional		$37.22	$49.26	$54.73
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 $24.92 / $32.99 / $36.65	Professional	TC	$24.92	$32.99	$36.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.10 / $33.33 / $48.52	Facility		$10.10	$33.33	$48.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $28.39 / $44.70	Professional		$10.48	$28.39	$44.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.11 / $53.76 / $117.48	Facility		$34.11	$53.76	$117.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.25 / $50.86 / $68.09	Professional		$35.25	$50.86	$68.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $15.78 / $20.96	Professional	26	$10.25	$15.78	$20.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $32.97 / $46.26	Professional	TC	$23.40	$32.97	$46.26
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $67.40 / $76.58	Professional		$58.80	$67.40	$76.58
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.79 / $20.26 / $22.62	Professional	26	$16.79	$20.26	$22.62
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $37.94 / $37.94 / $49.86	Professional	TC	$37.94	$37.94	$49.86
United Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $40.86 / $68.83	Professional		$34.04	$40.86	$68.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $13.10 / $20.84	Professional	26	$10.61	$13.10	$20.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $27.76 / $46.76	Professional	TC	$23.55	$27.76	$46.76