Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.03 / $106.80 / $308.67	Facility		$34.03	$106.80	$308.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.58 / $11.70 / $13.50	Facility	26	$10.58	$11.70	$13.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.45 / $28.11 / $308.67	Facility	TC	$23.45	$28.11	$308.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $34.03 / $61.50	Professional		$21.73	$34.03	$61.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $10.58 / $37.24	Professional	26	$6.94	$10.58	$37.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.45 / $42.04	Professional	TC	$18.82	$23.45	$42.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $41.23 / $47.07	Professional		$41.23	$41.23	$47.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $12.62 / $14.29	Professional	26	$6.31	$12.62	$14.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.94 / $26.94 / $26.94	Professional	TC	$26.94	$26.94	$26.94
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 $31.49 / $41.68 / $46.31	Professional		$31.49	$41.68	$46.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $12.50 / $13.89	Professional	26	$9.44	$12.50	$13.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $29.18 / $32.42	Professional	TC	$22.05	$29.18	$32.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.28 / $27.97 / $39.04	Facility		$7.28	$27.97	$39.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.50 / $23.83 / $35.94	Professional		$7.50	$23.83	$35.94
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 $28.70 / $40.76 / $55.70	Professional		$28.70	$40.76	$55.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.00 / $15.94	Professional	26	$7.95	$12.00	$15.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $26.88 / $39.44	Professional	TC	$19.64	$26.88	$39.44
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $47.41 / $54.13 / $54.13	Professional		$47.41	$54.13	$54.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.51 / $16.43	Professional	26	$12.59	$14.51	$16.43
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $30.98 / $30.98	Professional	TC	$30.98	$30.98	$30.98
United Facility/Professional Professional Modifier Low / Median / High Price $27.85 / $39.06 / $55.28	Professional		$27.85	$39.06	$55.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $9.88 / $15.75	Professional	26	$7.97	$9.88	$15.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $25.14 / $41.58	Professional	TC	$19.71	$25.14	$41.58