Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $114.82 / $275.42	Facility		$33.11	$114.82	$275.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $12.59 / $16.22	Facility	26	$10.23	$12.59	$16.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $27.54 / $302.00	Facility	TC	$21.38	$27.54	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $97.72	Professional		$20.89	$32.36	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.51 / $23.44	Professional	26	$7.08	$8.51	$23.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.50 / $36.31	Professional	TC	$14.13	$19.50	$36.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.70 / $44.67	Professional		$18.20	$25.70	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.12 / $15.14	Professional	26	$6.31	$9.12	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $20.89 / $29.51	Professional	TC	$14.45	$20.89	$29.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $147.91	Facility		$107.15	$107.15	$147.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $48.98	Professional		$33.11	$38.02	$48.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.96 / $14.13	Professional	26	$9.55	$10.96	$14.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $27.54 / $35.48	Professional	TC	$23.99	$27.54	$35.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $25.12 / $41.69	Facility		$8.32	$25.12	$41.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $20.89 / $40.74	Professional		$8.13	$20.89	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $52.48 / $199.53	Facility		$25.12	$52.48	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $39.81 / $56.23	Professional		$25.12	$39.81	$56.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $16.98	Professional	26	$7.94	$12.02	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.30 / $38.02	Professional	TC	$17.38	$26.30	$38.02
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $42.66 / $51.29	Professional		$26.30	$42.66	$51.29
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.49 / $17.38	Professional	26	$7.94	$15.49	$17.38
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $33.88	Professional	TC	$16.98	$28.84	$33.88
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $165.96 / $309.03	Facility		$128.82	$165.96	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.20 / $51.29	Professional		$25.12	$30.20	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $16.60	Professional	26	$7.94	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $35.48	Professional	TC	$16.98	$19.95	$35.48