Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.20 / $151.50 / $366.68	Facility		$47.20	$151.50	$366.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.67 / $14.19 / $17.92	Facility	26	$10.67	$14.19	$17.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.10 / $36.59 / $390.00	Facility	TC	$27.10	$36.59	$390.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $47.05 / $119.70	Professional		$35.47	$47.05	$119.70
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 $25.15 / $30.74 / $64.00	Professional	TC	$25.15	$30.74	$64.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $53.87 / $59.20	Professional		$43.98	$53.87	$59.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $17.27 / $18.88	Professional	26	$8.34	$17.27	$18.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.58 / $35.74 / $41.68	Professional	TC	$30.58	$35.74	$41.68
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 $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 $36.14 / $53.76 / $121.80	Facility		$36.14	$53.76	$121.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $51.50 / $70.00	Professional		$35.54	$51.50	$70.00
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 / $33.61 / $46.26	Professional	TC	$23.40	$33.61	$46.26
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $61.95 / $67.40 / $76.58	Professional		$61.95	$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 $35.17 / $41.10 / $49.86	Professional	TC	$35.17	$41.10	$49.86
United Facility/Professional Professional Modifier Low / Median / High Price $34.27 / $40.86 / $69.40	Professional		$34.27	$40.86	$69.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.59 / $13.10 / $21.16	Professional	26	$10.59	$13.10	$21.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $32.47 / $50.62	Professional	TC	$23.55	$32.47	$50.62