Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.36 / $138.90 / $438.47	Facility		$51.36	$138.90	$438.47
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.86 / $13.14 / $36.54	Facility	26	$9.86	$13.14	$36.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.64 / $178.44 / $643.28	Facility	TC	$22.64	$178.44	$643.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.92 / $38.89 / $83.40	Professional		$11.92	$38.89	$83.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $11.92 / $43.20	Professional	26	$8.15	$11.92	$43.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.89 / $44.44 / $140.00	Professional	50	$16.89	$44.44	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.45 / $56.00	Professional	TC	$19.14	$23.45	$56.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $44.54 / $56.96	Professional		$35.86	$44.54	$56.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $14.50 / $16.51	Professional	26	$7.03	$14.50	$16.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.13 / $29.13 / $38.36	Professional	TC	$29.13	$29.13	$38.36
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 $30.66 / $40.58 / $45.09	Professional		$30.66	$40.58	$45.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $13.68 / $15.20	Professional	26	$10.34	$13.68	$15.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.32 / $26.90 / $29.89	Professional	TC	$20.32	$26.90	$29.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.51 / $29.50 / $42.34	Facility		$8.51	$29.50	$42.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.80 / $25.13 / $38.99	Professional		$8.80	$25.13	$38.99
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 $30.73 / $43.01 / $59.01	Professional		$30.73	$43.01	$59.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $13.39 / $17.59	Professional	26	$8.63	$13.39	$17.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.32 / $27.39 / $40.68	Professional	TC	$20.32	$27.39	$40.68
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $51.22 / $51.22 / $65.50	Professional		$51.22	$51.22	$65.50
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $17.70 / $18.98	Professional	26	$14.17	$17.70	$18.98
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $42.39 / $44.11	Professional	TC	$33.50	$42.39	$44.11
United Facility/Professional Professional Modifier Low / Median / High Price $27.93 / $33.93 / $60.41	Professional		$27.93	$33.93	$60.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $10.99 / $17.76	Professional	26	$8.94	$10.99	$17.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $25.93 / $43.87	Professional	TC	$19.71	$25.93	$43.87