Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.75 / $23.28 / $29.23	Facility	26	$20.75	$23.28	$29.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.04 / $75.26 / $110.69	Professional		$54.04	$75.26	$110.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $19.93 / $26.76	Professional	26	$12.51	$19.93	$26.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.25 / $53.90 / $84.02	Professional	TC	$37.25	$53.90	$84.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $100.73 / $100.73	Professional		$48.40	$100.73	$100.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $24.84 / $26.89	Professional	26	$13.51	$24.84	$26.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.12 / $78.25 / $86.94	Professional		$59.12	$78.25	$86.94
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $23.81 / $26.45	Professional	26	$17.98	$23.81	$26.45
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 $14.32 / $45.69 / $69.01	Professional		$14.32	$45.69	$69.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $88.72 / $112.53	Professional		$56.77	$88.72	$112.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.29 / $22.94 / $30.46	Professional	26	$15.29	$22.94	$30.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.13 / $61.90 / $77.37	Professional	TC	$42.13	$61.90	$77.37
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $115.84 / $115.84	Professional		$115.84	$115.84	$115.84
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $27.15 / $29.68 / $30.92	Professional	26	$27.15	$29.68	$30.92
United Facility/Professional Professional Modifier Low / Median / High Price $55.70 / $72.90 / $108.49	Professional		$55.70	$72.90	$108.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.29 / $18.73 / $31.00	Professional	26	$14.29	$18.73	$31.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $54.16 / $80.55	Professional	TC	$40.22	$54.16	$80.55