Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.08 / $121.55 / $413.60	Facility		$40.08	$121.55	$413.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.99 / $14.19 / $17.38	Facility	26	$13.99	$14.19	$17.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.89 / $31.10 / $254.91	Facility	TC	$25.89	$31.10	$254.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $40.08 / $87.55	Professional		$28.69	$40.08	$87.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $14.19 / $28.10	Professional	26	$9.11	$14.19	$28.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $25.89 / $43.69	Professional	TC	$19.93	$25.89	$43.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.38 / $48.83 / $55.48	Professional		$48.38	$48.83	$55.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $15.64 / $18.14	Professional	26	$7.26	$15.64	$18.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.21 / $30.23 / $33.50	Professional	TC	$29.21	$30.23	$33.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $107.60 / $117.07	Facility		$107.60	$107.60	$117.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.75 / $45.99 / $51.10	Professional		$34.75	$45.99	$51.10
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 $22.45 / $29.72 / $33.02	Professional	TC	$22.45	$29.72	$33.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.16 / $26.82 / $40.46	Facility		$9.16	$26.82	$40.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.48 / $22.85 / $37.19	Professional		$9.48	$22.85	$37.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.08 / $53.76 / $121.80	Facility		$32.08	$53.76	$121.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $45.12 / $60.99	Professional		$30.97	$45.12	$60.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $15.44 / $20.44	Professional	26	$10.08	$15.44	$20.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.45 / $28.64 / $38.27	Professional	TC	$20.45	$28.64	$38.27
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $55.64 / $56.15 / $63.80	Professional		$55.64	$56.15	$63.80
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $17.98 / $20.87	Professional	26	$9.17	$17.98	$20.87
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $20.03 / $34.76 / $38.53	Professional	TC	$20.03	$34.76	$38.53
United Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $37.83 / $60.80	Professional		$29.38	$37.83	$60.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.42 / $11.87 / $19.45	Professional	26	$9.42	$11.87	$19.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.92 / $23.55 / $41.63	Professional	TC	$19.92	$23.55	$41.63