Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.40 / $102.90 / $339.09	Facility		$32.40	$102.90	$339.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.05 / $11.70 / $13.52	Facility	26	$11.05	$11.70	$13.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.23 / $27.92 / $264.97	Facility	TC	$22.23	$27.92	$264.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $33.28 / $73.20	Professional		$26.46	$33.28	$73.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.56 / $18.89	Professional	26	$7.33	$10.56	$18.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $22.23 / $42.04	Professional	TC	$19.14	$22.23	$42.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.89 / $42.89 / $48.11	Professional		$42.89	$42.89	$48.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $13.70 / $15.30	Professional	26	$7.68	$13.70	$15.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.94 / $34.94 / $36.36	Professional	TC	$34.94	$34.94	$36.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.62 / $76.62 / $83.36	Facility		$76.62	$76.62	$83.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $40.99 / $45.54	Professional		$30.97	$40.99	$45.54
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 $21.40 / $28.32 / $31.47	Professional	TC	$21.40	$28.32	$31.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.90 / $27.97 / $39.90	Facility		$7.90	$27.97	$39.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.14 / $23.83 / $36.71	Professional		$8.14	$23.83	$36.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $53.76 / $112.48	Facility		$29.78	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.93 / $40.76 / $55.80	Professional		$28.93	$40.76	$55.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $12.02 / $16.30	Professional	26	$8.01	$12.02	$16.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $26.88 / $38.82	Professional	TC	$19.64	$26.88	$38.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $49.32 / $55.33 / $55.88	Professional		$49.32	$55.33	$55.88
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $15.76 / $17.60	Professional	26	$10.53	$15.76	$17.60
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $28.87 / $41.81	Professional	TC	$28.87	$28.87	$41.81
United Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $34.94 / $57.17	Professional		$27.90	$34.94	$57.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $12.63 / $16.46	Professional	26	$8.30	$12.63	$16.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.78 / $26.88 / $41.03	Professional	TC	$19.78	$26.88	$41.03