Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.73 / $20.81 / $25.07	Facility	26	$19.73	$20.81	$25.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $60.90 / $131.83	Professional		$47.71	$60.90	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $19.87 / $33.86	Professional	26	$12.13	$19.87	$33.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $39.03 / $89.60	Professional	TC	$33.61	$39.03	$89.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $79.70 / $80.50	Professional		$68.73	$79.70	$80.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.21 / $23.08 / $24.74	Professional	26	$10.21	$23.08	$24.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.89 / $37.89 / $43.99	Professional	TC	$37.89	$37.89	$43.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.32 / $67.92 / $75.47	Professional		$51.32	$67.92	$75.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $22.81 / $25.34	Professional	26	$17.23	$22.81	$25.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $45.12 / $50.13	Professional	TC	$34.09	$45.12	$50.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.80 / $40.14 / $60.89	Professional		$12.80	$40.14	$60.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.35 / $69.98 / $90.30	Professional		$47.35	$69.98	$90.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $21.48 / $28.11	Professional	26	$13.69	$21.48	$28.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.59 / $44.51 / $63.62	Professional	TC	$31.59	$44.51	$63.62
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $64.56 / $91.66 / $102.20	Professional		$64.56	$91.66	$102.20
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $18.96 / $26.54 / $28.45	Professional	26	$18.96	$26.54	$28.45
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $43.57 / $50.59 / $50.59	Professional	TC	$43.57	$50.59	$50.59
United Facility/Professional Professional Modifier Low / Median / High Price $44.59 / $54.18 / $93.04	Professional		$44.59	$54.18	$93.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.34 / $15.82 / $26.45	Professional	26	$13.34	$15.82	$26.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.29 / $37.53 / $66.92	Professional	TC	$29.29	$37.53	$66.92