Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.61 / $23.02 / $29.23	Facility	26	$22.61	$23.02	$29.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $67.65 / $141.51	Professional		$55.33	$67.65	$141.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $21.96 / $38.47	Professional	26	$12.69	$21.96	$38.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $50.93 / $73.79	Professional	TC	$39.22	$50.93	$73.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.80 / $101.80 / $101.80	Professional		$101.80	$101.80	$101.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $23.58 / $29.42	Professional	26	$10.74	$23.58	$29.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.09 / $80.86 / $89.84	Professional		$61.09	$80.86	$89.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.96 / $26.42 / $29.35	Professional	26	$19.96	$26.42	$29.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.13 / $54.44 / $60.49	Professional	TC	$41.13	$54.44	$60.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.02 / $46.67 / $69.75	Professional		$14.02	$46.67	$69.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.68 / $85.27 / $113.12	Professional		$58.68	$85.27	$113.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.82 / $24.87 / $32.39	Professional	26	$15.82	$24.87	$32.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.34 / $59.39 / $81.23	Professional	TC	$42.34	$59.39	$81.23
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $26.06 / $27.12 / $33.50	Professional	26	$26.06	$27.12	$33.50
United Facility/Professional Professional Modifier Low / Median / High Price $55.45 / $66.30 / $108.49	Professional		$55.45	$66.30	$108.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $18.79 / $30.85	Professional	26	$14.43	$18.79	$30.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.59 / $47.58 / $81.73	Professional	TC	$39.59	$47.58	$81.73