Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $102.33 / $338.84	Facility		$26.92	$102.33	$338.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $11.48 / $13.80	Facility	26	$10.96	$11.48	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $26.92 / $177.83	Facility	TC	$22.39	$26.92	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $33.11 / $83.18	Professional		$21.88	$33.11	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $20.89	Professional	26	$6.03	$8.91	$20.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.39 / $48.98	Professional	TC	$15.85	$22.39	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $30.20 / $51.29	Professional		$20.42	$30.20	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.51 / $15.14	Professional	26	$6.31	$8.51	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $38.02	Professional	TC	$17.38	$21.38	$38.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $104.71	Facility		$75.86	$75.86	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $35.48 / $45.71	Professional		$30.90	$35.48	$45.71
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 $21.38 / $24.55 / $31.62	Professional	TC	$21.38	$24.55	$31.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $29.51 / $48.98	Facility		$8.32	$29.51	$48.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $25.70 / $48.98	Professional		$8.13	$25.70	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $52.48 / $162.18	Facility		$29.51	$52.48	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $61.66	Professional		$27.54	$40.74	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $18.20	Professional	26	$7.94	$12.02	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $41.69	Professional	TC	$19.50	$26.92	$41.69
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $57.54	Professional		$35.48	$54.95	$57.54
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.14 / $17.38	Professional	26	$8.32	$15.14	$17.38
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $43.65	Professional	TC	$22.39	$27.54	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $138.04 / $257.04	Facility		$107.15	$138.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $56.23	Professional		$27.54	$32.36	$56.23
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 $19.50 / $22.91 / $40.74	Professional	TC	$19.50	$22.91	$40.74