Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.35 / $110.40 / $349.38	Facility		$37.35	$110.40	$349.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.05 / $12.59 / $16.05	Facility	26	$11.05	$12.59	$16.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.40 / $27.58 / $277.81	Facility	TC	$21.40	$27.58	$277.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $37.35 / $60.95	Professional		$24.30	$37.35	$60.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $11.05 / $26.42	Professional	26	$7.71	$11.05	$26.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $24.14 / $33.92	Professional	TC	$16.35	$24.14	$33.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.37 / $42.34 / $42.34	Professional		$41.37	$42.34	$42.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $13.44 / $14.69	Professional	26	$6.52	$13.44	$14.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.20 / $28.20 / $29.67	Professional	TC	$28.20	$28.20	$29.67
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 $33.44 / $44.25 / $49.17	Professional		$33.44	$44.25	$49.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $12.66 / $14.07	Professional	26	$9.57	$12.66	$14.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $31.59 / $35.10	Professional	TC	$23.87	$31.59	$35.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.90 / $22.61 / $34.34	Facility		$7.90	$22.61	$34.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.14 / $19.26 / $31.50	Professional		$8.14	$19.26	$31.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.94 / $53.76 / $121.80	Facility		$24.94	$53.76	$121.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $40.34 / $53.89	Professional		$28.15	$40.34	$53.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $12.40 / $16.30	Professional	26	$8.01	$12.40	$16.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $26.39 / $37.56	Professional	TC	$18.05	$26.39	$37.56
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $39.78 / $48.07 / $48.69	Professional		$39.78	$48.07	$48.69
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.12 / $15.76 / $17.60	Professional	26	$13.12	$15.76	$17.60
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $32.43 / $32.43 / $34.11	Professional	TC	$32.43	$32.43	$34.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.42 / $31.84 / $51.97	Professional		$25.42	$31.84	$51.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $13.02 / $16.46	Professional	26	$8.30	$13.02	$16.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $25.39 / $35.04	Professional	TC	$17.23	$25.39	$35.04